0001104659-21-068828.txt : 20210518
0001104659-21-068828.hdr.sgml : 20210518
20210518160603
ACCESSION NUMBER: 0001104659-21-068828
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210514
FILED AS OF DATE: 20210518
DATE AS OF CHANGE: 20210518
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Baker David Charles
CENTRAL INDEX KEY: 0001844060
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-40034
FILM NUMBER: 21935991
MAIL ADDRESS:
STREET 1: 100 N. 18TH STREET
STREET 2: SUITE 300
CITY: PHILADELPHIA
STATE: PA
ZIP: 19103
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Vallon Pharmaceuticals, Inc.
CENTRAL INDEX KEY: 0001824293
STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834]
IRS NUMBER: 824369909
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: TWO LOGAN SQUARE
STREET 2: 100 N. 18TH STREET, SUITE 300
CITY: PHILADELPHIA
STATE: PA
ZIP: 19103
BUSINESS PHONE: (267) 207-3606
MAIL ADDRESS:
STREET 1: TWO LOGAN SQUARE
STREET 2: 100 N. 18TH STREET, SUITE 300
CITY: PHILADELPHIA
STATE: PA
ZIP: 19103
4
1
tm2116776-2_4.xml
OWNERSHIP DOCUMENT
X0306
4
2021-05-14
0
0001824293
Vallon Pharmaceuticals, Inc.
VLON
0001844060
Baker David Charles
C/O VALLON PHARMACEUTICALS, INC.
100 N. 18TH STREET, SUITE 300
PHILADELPHIA
PA
19103
1
1
0
0
Chief Executive Officer
Stock Option (Right to Buy)
3.66
2021-05-14
4
A
0
100000
0.00
A
2031-05-14
Common Stock
100000
100000
D
Vests as to 25% of the underlying shares of common stock on the first annual anniversary of the date of grant, then in 12 equal quarterly installments such that the stock option is fully vested on the fourth annual anniversary of the date of grant.
/s/ David Baker
2021-05-18