Filing Details

Accession Number:
0001354488-12-000797
Form Type:
4
Zero Holdings:
No
Publication Time:
2012-02-21 17:31:26
Reporting Period:
2012-02-16
Filing Date:
2012-02-21
Accepted Time:
2012-02-21 17:31:26
SEC Url:
Form 4 Filing
Issuer
Cik Name Symbol Sector (SIC) IRS No
1054274 Alliqua Inc. ALQA.OB Surgical & Medical Instruments & Apparatus (3841) 582349413
Insiders
Cik Name Reported Address Insider Title Director Officer Large Shareholder Other
905011 M Michael Goldberg 850 Third Avenue
Suite 1801
New York NY 10022
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 2012-02-16 2,000,000 $0.00 2,250,000 No 4 P Direct
Equity Swap Involved Form Type Code Nature of Ownership Explanation
No 4 P Direct
Reported Derivative Transactions
Sec. Name Sec. Type Acquisiton - Disposition Date Amount Price Amount - 2 Price - 2
Common Stock Common Stock Warrants (right to buy) Acquisiton 2012-02-16 1,000,000 $0.00 1,000,000 $0.07
Remaning Holdings Exercise Date Expiration Date Equity Swap Involved Transaction Form Type Transaction Code Nature of Ownership
3,250,000 2012-02-16 2017-02-16 No 4 P Direct
Footnotes
  1. Dr. Goldstein purchased, as part of a private placement transaction on February 16, 2012, 2,000,000 units at a price per unit of $0.05, with each unit consisting of 1 share of common stock and a warrant to purchase 0.5 of a share of common stock