0001104659-20-135877.txt : 20201215 0001104659-20-135877.hdr.sgml : 20201215 20201215192524 ACCESSION NUMBER: 0001104659-20-135877 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20201215 FILED AS OF DATE: 20201215 DATE AS OF CHANGE: 20201215 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Gibson Robert J CENTRAL INDEX KEY: 0001821615 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39788 FILM NUMBER: 201390871 MAIL ADDRESS: STREET 1: 71 LANTERN RIDGE RD CITY: NEW CANAAN STATE: CT ZIP: 06840 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Scopus BioPharma Inc. CENTRAL INDEX KEY: 0001772028 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 821248020 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 420 LEXINGTON AVENUE, SUITE 300 CITY: NEW YORK STATE: NY ZIP: 10170 BUSINESS PHONE: (212) 479-2513 MAIL ADDRESS: STREET 1: 420 LEXINGTON AVENUE, SUITE 300 CITY: NEW YORK STATE: NY ZIP: 10170 FORMER COMPANY: FORMER CONFORMED NAME: Scopus Biopharma Inc. DATE OF NAME CHANGE: 20190327 3 1 tm2038482-4_3.xml OWNERSHIP DOCUMENT X0206 3 2020-12-15 0 0001772028 Scopus BioPharma Inc. SCPS 0001821615 Gibson Robert J C/O SCOPUS BIOPHARMA INC. 420 LEXINGTON AVENUE, SUITE 300 NEW YORK NY 10170 1 1 0 0 Vice Chairman Common Stock, par value $0.001 2000 D Common Stock, par value $0.001 210052 I Dayber Snow LLC Common Stock, par value $0.001 200000 I HCFP/Capital Partners 18B-1 LLC W Warrant 4.00 2021-10-01 2026-09-30 B Unit 6668 I Dayber Snow LLC W Warrant 4.00 2021-10-01 2026-09-30 B Unit 769500 I HCFP/Capital Partners 18B-2 LLC Includes an aggregate of 2,000 shares held by Mr. Gibson's minor children. Includes shares held by Dayber Snow LLC, of which Mr. Gibson is a member and co-manager. Accordingly, he is deemed to have shared voting and dispositive power over the shares held by this entity. Does not have voting or dispositive power over the shares held by this entity. Mr. Gibson disclaims beneficial ownership of shares held by this entity, except to the extent of his proportionate pecuniary interest therein. Each W Warrant is exercisable for one B Unit. Starting on April 1, 2022, each B Unit can be separated into one share of common stock and one Z Warrant. Each Z warrant is exercisable for one share of common stock with an exercise price of $5.00 per share. The Z Warrant will become exercisable on July 1, 2022 and will expire on June 30, 2027. Includes securities held by Dayber Snow LLC, of which Mr. Gibson is a member and co-manager, and HCFP/Capital Partners 18B-2 LLC, over which securities Mr. Gibson does not have voting or dispositive power. Accordingly, he is deemed to have shared voting and dispositive power and no voting and dispositive power over the securities held by Dayber Snow LLC and HCFP/Capital Partners 18B-2 LLC, respectively. Mr. Gibson disclaims beneficial ownership of securities held by these entities, except to the extent of his proportionate pecuniary interest therein. /s/ Robert J. Gibson 2020-12-15