Filing Details
- Accession Number:
- 0001213900-18-010083
- Form Type:
- 4
- Zero Holdings:
- No
- Publication Time:
- 2018-08-02 16:03:09
- Reporting Period:
- 2018-07-31
- Accepted Time:
- 2018-08-02 16:03:09
- SEC Url:
- Form 4 Filing
Issuer
Cik | Name | Symbol | Sector (SIC) | IRS No |
---|---|---|---|---|
1513525 | Adial Pharmaceuticals Inc. | ADIL | Pharmaceutical Preparations (2834) | 800667150 |
Insiders
Cik | Name | Reported Address | Insider Title | Director | Officer | Large Shareholder | Other |
---|---|---|---|---|---|---|---|
1718351 | H. Robertson Gilliland | 1180 Seminole Trail, Suite 495 Charlottesville, VA 22901 | Yes | No | No | No |
Reported Non-Derivative Transactions
Sec. Name | Acquisiton - Disposition | Date | Amount | Price | Remaning Holdings | Equity Swap Involved | Form Type | Code | Nature of Ownership | Explanation |
---|---|---|---|---|---|---|---|---|---|---|
Common Stock | Acquisiton | 2018-07-31 | 29,931 | $0.00 | 95,424 | No | 4 | C | Indirect | Owned by Keller Enterprises, LLC |
Common Stock | Acquisiton | 2018-07-31 | 14,000 | $0.00 | 109,424 | No | 4 | P | Indirect | Owned by Keller Enterprises, LLC |
Equity Swap Involved | Form Type | Code | Nature of Ownership | Explanation |
---|---|---|---|---|
No | 4 | C | Indirect | Owned by Keller Enterprises, LLC |
No | 4 | P | Indirect | Owned by Keller Enterprises, LLC |
Reported Derivative Transactions
Sec. Name | Sec. Type | Acquisiton - Disposition | Date | Amount | Price | Amount - 2 | Price - 2 |
---|---|---|---|---|---|---|---|
Common Stock | Convertible Note | Disposition | 2018-07-31 | 29,931 | $0.00 | 29,931 | $0.44 |
Common Stock | Warrant to purchase common stock | Acquisiton | 2018-07-31 | 29,931 | $0.00 | 29,931 | $6.25 |
Common Stock | Warrant to purchase common stock | Acquisiton | 2018-07-31 | 14,000 | $0.00 | 43,931 | $6.25 |
Remaning Holdings | Exercise Date | Expiration Date | Equity Swap Involved | Transaction Form Type | Transaction Code | Nature of Ownership |
---|---|---|---|---|---|---|
0 | No | 4 | C | Indirect | ||
29,931 | 2018-07-31 | 2023-07-31 | No | 4 | C | Indirect |
43,931 | 2018-07-31 | 2023-07-31 | No | 4 | P | Indirect |
Footnotes
- The 29,931 shares of common stock and a warrant to purchase 29,931 shares of common stock were issued upon automatic conversion of a convertible note in the principal amount of $10,000 at a conversion price of $0.44 per share upon consummation of the initial public offering of the issuer on July 31, 2018.
- Mr. Gilliland is the principal of Keller Enterprises, LLC ("Keller").
- On July 31, 2018, Keller purchased 14,000 units (the "Units") in the initial public offering of the issuer at a price of $5.00 per Unit, which corresponds to a price of $4.99 per share of common stock and $0.01 per warrant. Each Unit consisted of one share of common stock and a warrant to purchase one share of common stock. The shares of common stock and warrants were immediately separable upon issuance of the Units in the IPO.