Amended Statement of Changes in Beneficial Ownership (4/a)
November 25 2020 - 4:51PM
Edgar (US Regulatory)
FORM 4
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
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Schuyler Kevin |
2. Issuer Name and Ticker or Trading Symbol
ADIAL PHARMACEUTICALS, INC.
[
ADIL
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director _____ 10% Owner _____ Officer (give title below) _____ Other (specify below)
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(Last)
(First)
(Middle)
1180 SEMINOLE TRAIL, SUITE 495 |
3. Date of Earliest Transaction
(MM/DD/YYYY)
7/31/2018 |
(Street)
CHARLOTTESVILLE, VA 22901
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
8/2/2018 |
6. Individual or Joint/Group Filing
(Check Applicable Line)
_X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security (Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code (Instr. 8)
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4. Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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Common Stock | 7/31/2018 | | J | | 89600 (1) | A | (1) | 222990 | D | |
Common Stock | 7/31/2018 | | P | | 90000 (6) | A | (6) | 312990 | D | |
Common Stock | 7/31/2018 | | J | | 144200 (2) | A | (2) | 144200 | I | Owned by MVA 151 Investors, LLC (6) |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Trans. Date | 3A. Deemed Execution Date, if any | 4. Trans. Code (Instr. 8) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) | 6. Date Exercisable and Expiration Date | 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) | 8. Price of Derivative Security (Instr. 5) | 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) | 10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) |
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Warrant to purchase common stock | $6.25 | 7/31/2018 | | J | | 89600 | | 7/31/2018 | 7/31/2023 | Common Stock (1) | 89600 | (1) | 89600 | D | |
Warrant to purchase common stock | $6.25 | 7/31/2018 | | P | | 90000 (6) | | 7/31/2018 | 7/31/2023 | Common Stock | 90000 | (6) | 90000 | D | |
Warrant to purchase common stock | $6.25 | 7/31/2018 | | J | | 192600 | | 7/31/2018 | 7/31/2023 | Common Stock (2) | 192200 | (2) | 192600 | I | Owned by MVA 151 Investors, LLC (5) |
Warrant to purchase units | $5.00 | 7/31/2018 | | J | | 89600 | | 7/31/2018 | 7/31/2023 | Units (3) | 179200 | (3) | 89600 | D | |
Warrant to purchase units | $5.00 | 7/31/2018 | | J | | 192600 | | 7/31/2018 | 7/31/2023 | Units (4) | 385200 | (4) | 192600 | I | Owned by MVA 151 Investors, LLC (5) |
Explanation of Responses: |
(1) | The original warrant number and shares issuable upon exercise of the warrant is being corrected to reflect 89,600 shares of common stock and warrants to purchase 89,600 shares of common stock that were received by the reporting person upon consummation of the initial public offering in accordance with a Securities Purchase Agreement dated February 22, 2018. |
(2) | The original warrant number and shares issuable upon exercise of the warrant is being corrected to reflect 192,600 shares of common stock and warrants to purchase 192,600 shares of common stock were received by the reporting person upon consummation of the initial public offering in accordance with a Securities Purchase Agreement dated February 22, 2018. |
(3) | The original warrant number and shares issuable upon exercise of the warrant is being corrected to reflect the purchase 89,600 units was received by the reporting person upon consummation of the initial public offering in accordance with a Securities Purchase Agreement dated February 22, 2018. Each unit consisted of a share of common stock and a warrant to purchase a share of common stock. The aggregate number of shares of common stock included in the units and underlying the warrants included in the units is 179,200 shares. |
(4) | The original warrant number and shares issuable upon exercise of the warrant is being corrected to reflect 192,600 units was received by MVA 151 Investors LLC upon consummation of the initial public offering in accordance with a Securities Purchase Agreement dated February 22, 2018. Each unit consisted of a share of common stock and a warrant to purchase a share of common stock. The aggregate number of shares of common stock included in the units and underlying the warrants included in the units is 385,200 shares. |
(5) | Mr. Schuyler has control over MVA 151 Investors, LLC. |
(6) | The original warrant number and units issuable upon exercise of the warrant is being corrected to reflect On July 31, 2018, Mr. Schuyler purchased 90,000 units (the "Units") in the initial public offering 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 initial public offering. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Schuyler Kevin 1180 SEMINOLE TRAIL, SUITE 495 CHARLOTTESVILLE, VA 22901 | X |
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Signatures
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/s/ Kevin Schuyler | | 11/25/2020 |
**Signature of Reporting Person | Date |
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