SEC Form 4 · accession 0001214659-17-007049
NEXIEN BIOPHARMA, INC. · NXEN
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Robert I Goldfarb
Officer — Chief Operating Officer
Period of report
Nov 29, 2017
Accepted (ET)
Dec 1, 2017 · 10:37 am EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001625288
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1,F2 | Nov 29, 2017 | J | 644,227 | — | A | 1,024,000 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Class A Warrants (right to buy)F3 | $0.25 | Nov 29, 2017 | J | 2,400 | A | Nov 29, 2017 | Jan 31, 2018 | Common Stock | 2,400 | 2,400 | D |
| Class B Warrants (right to buy)F4 | $0.375 | Nov 29, 2017 | J | 2,400 | A | Nov 29, 2017 | May 7, 2018 | Common Stock | 2,400 | 2,400 | D |
| Class C Warrants (right to buy)F5 | $0.50 | Nov 29, 2017 | J | 2,400 | A | Nov 29, 2017 | Jul 14, 2018 | Common Stock | 2,400 | 2,400 | D |
Explanation of responses
- F1As adjusted to reflect a one-for-six reverse split of the issuer's common stock effective November 29, 2017
- F2Acquired in exchange for all of Robert Goldfarb's shares of Intiva BioPharma Inc.
- F3Acquired in exchange for all of Robert Goldfarb's Class A warrants of Intiva BioPharma Inc.
- F4Acquired in exchange for all of Robert Goldfarb's Class B warrants of Intiva BioPharma Inc.
- F5Acquired in exchange for all of Robert Goldfarb's Class C warrants of Intiva BioPharma Inc.