SEC Form 4 · accession 0001213900-18-010099
ADIAL PHARMACEUTICALS, INC. · ADIL
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Joseph Truluck
Officer — Chief Financial Officer
Period of report
Jul 31, 2018
Accepted (ET)
Aug 2, 2018 · 4:16 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001513525
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | Jul 31, 2018 | C | 5,927 | — | A | 80,555 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Convertible NoteF1 | $0.44 | Jul 31, 2018 | C | 5,927 | D | — | — | Common Stock | 5,927 | 0 | D |
| WarrantF1 | $6.25 | Jul 31, 2018 | C | 5,927 | A | Jul 31, 2018 | Jul 31, 2023 | Common Stock | 5,927 | 5,927 | D |
Explanation of responses
- F1The 5,927 shares of common stock and a warrant to purchase 5,927 shares of common stock were issued upon automatic conversion of a convertible note in the principal amount of $1,980 at a conversion price of $0.44 per share upon consummation of the initial public offering on July 31, 2018.