o NoneEntity Type
0001427925
SuRx, Inc.
 
x Corporation
o Limited Partnership
o Limited Liability Company
o General Partnership
o Business Trust
o Other
Name of Issuer
 ACELRX PHARMACEUTICALS INC
Jurisdiction of Incorporation/OrganizationDELAWARE 
Year of Incorporation/Organization
  x Over Five Years Ago
  o Within Last Five Years (Specify Year)  
  o Yet to Be Formed 



2. Principal Place of Business and Contact Information
Name of Issuer 
 ACELRX PHARMACEUTICALS INC 
Street Address 1Street Address 2
 25821 Industrial Boulevard, Suite 400 
CityState/Province/CountryZIP/Postal CodePhone No. of Issuer
 Hayward CALIFORNIA 94545 650-216-3500 



3. Related Persons
Last NameFirst NameMiddle Name
AngottiVincent
Street Address 1Street Address 2
25821 Industrial BoulevardSuite 400
CityState/Province/CountryZIP/Postal Code
HaywardCALIFORNIA94545
Relationship: x Executive Officer x Director o Promoter
Clarification of Response (if Necessary)
  

Last NameFirst NameMiddle Name
AfableRichard
Street Address 1Street Address 2
25821 Industrial Boulevard, Suite 400
CityState/Province/CountryZIP/Postal Code
HaywardCALIFORNIA94545
Relationship: o Executive Officer x Director o Promoter
Clarification of Response (if Necessary)
  

Last NameFirst NameMiddle Name
BozilenkoMarina
Street Address 1Street Address 2
25821 Industrial BoulevardSuite 400
CityState/Province/CountryZIP/Postal Code
HaywardCALIFORNIA94545
Relationship: o Executive Officer x Director o Promoter
Clarification of Response (if Necessary)
  

Last NameFirst NameMiddle Name
EdwardsMark
Street Address 1Street Address 2
25821 Industrial BoulevardSuite 400
CityState/Province/CountryZIP/Postal Code
HaywardCALIFORNIA94545
Relationship: o Executive Officer x Director o Promoter
Clarification of Response (if Necessary)
  

 
Last NameFirst NameMiddle Name
HoffmanStephen
Street Address 1Street Address 2
25821 Industrial BoulevardSuite 400
CityState/Province/CountryZIP/Postal Code
HaywardCALIFORNIA94545
Relationship: o Executive Officer x Director o Promoter
Clarification of Response (if Necessary)
  

Last NameFirst NameMiddle Name
AsadorianRaffi
Street Address 1Street Address 2
25821 Industrial BoulevardSuite 400
CityState/Province/CountryZIP/Postal Code
HaywardCALIFORNIA94545
Relationship: x Executive Officer o Director o Promoter
Clarification of Response (if Necessary)
  

Last NameFirst NameMiddle Name
PalmerPamela
Street Address 1Street Address 2
25821 Industrial BoulevardSuite 400
CityState/Province/CountryZIP/Postal Code
HaywardCALIFORNIA94545
Relationship: x Executive Officer x Director o Promoter
Clarification of Response (if Necessary)
  

Last NameFirst NameMiddle Name
DasuBadri
Street Address 1Street Address 2
25821 Industrial BoulevardSuite 400
CityState/Province/CountryZIP/Postal Code
HaywardCALIFORNIA94545
Relationship: x Executive Officer o Director o Promoter
Clarification of Response (if Necessary)
  

 
Last NameFirst NameMiddle Name
AdamsAdrian
Street Address 1Street Address 2
25821 Industrial BoulevardSuite 400
CityState/Province/CountryZIP/Postal Code
HaywardCALIFORNIA94545
Relationship: o Executive Officer x Director o Promoter
Clarification of Response (if Necessary)
  

Last NameFirst NameMiddle Name
RosenHoward
Street Address 1Street Address 2
25821 Industrial BoulevardSuite 400
CityState/Province/CountryZIP/Postal Code
HaywardCALIFORNIA94545
Relationship: o Executive Officer x Director o Promoter
Clarification of Response (if Necessary)
  

Last NameFirst NameMiddle Name
WanMark
Street Address 1Street Address 2
25821 Industrial BoulevardSuite 400
CityState/Province/CountryZIP/Postal Code
HaywardCALIFORNIA94545
Relationship: o Executive Officer x Director o Promoter
Clarification of Response (if Necessary)
  

Last NameFirst NameMiddle Name
BroadfootJill
Street Address 1Street Address 2
25821 Industrial BoulevardSuite 400
CityState/Province/CountryZIP/Postal Code
HaywardCALIFORNIA94545
Relationship: o Executive Officer x Director o Promoter
Clarification of Response (if Necessary)
  

 


4. Industry Group
o Agriculture Health Care o Retailing
 Banking & Financial Services   o Biotechnology o Restaurants
  o Commercial Banking   o Health Insurance Technology
  o Insurance  o Hospitals & Physicians  o Computers
  o Investing  x Pharmaceuticals  o Telecommunications
  o Investment Banking  o Other Health Care  o Other Technology
  o Pooled Investment Fund

    Travel
  o Other Banking & Financial Services o Manufacturing  o Airlines & Airports
 Real Estate  o Lodging & Conventions
  o Commercial  o Tourism & Travel Services
  o Construction  o Other Travel
  o REITS & Finance o Other
  o Residential 
  o Other Real Estate 
o Business Services 
 Energy 
  o Coal Mining 
  o Electric Utilities 
  o Energy Conservation 
  o Environmental Services 
  o Oil & Gas 
  o Other Energy 


5. Issuer Size
Revenue RangeAggregate Net Asset Value Range
o No Revenues o No Aggregate Net Asset Value
o $1 - $1,000,000 o $1 - $5,000,000
o $1,000,001 - $5,000,000 o $5,000,001 - $25,000,000
o $5,000,001 - $25,000,000 o $25,000,001 - $50,000,000
o $25,000,001 - $100,000,000 o $50,000,001 - $100,000,000
o Over $100,000,000 o Over $100,000,000
x Decline to Disclose o Decline to Disclose
o Not Applicable o Not Applicable


6. Federal Exemption(s) and Exclusion(s) Claimed (select all that apply)
o Rule 504(b)(1) (not (i), (ii) or (iii)) o Rule 505
o Rule 504 (b)(1)(i) x Rule 506(b)
o Rule 504 (b)(1)(ii) o Rule 506(c)
o Rule 504 (b)(1)(iii) o Securities Act Section 4(a)(5)
  o Investment Company Act Section 3(c)

7. Type of Filing
x New Notice Date of First Sale 2022-01-07 o First Sale Yet to Occur
o Amendment

8. Duration of Offering
Does the Issuer intend this offering to last more than one year? o Yes x No

9. Type(s) of Securities Offered (select all that apply)
o Pooled Investment Fund Interests x Equity
o Tenant-in-Common Securities o Debt
o Mineral Property Securities o Option, Warrant or Other Right to Acquire Another Security
o Security to be Acquired Upon Exercise of Option, Warrant or Other Right to Acquire Security o Other (describe)
  


10. Business Combination Transaction
Is this offering being made in connection with a business combination transaction, such as a merger, acquisition or exchange offer? x Yes o No
 
Clarification of Response (if Necessary) 
  

11. Minimum Investment
Minimum investment accepted from any outside investor$ 0 USD

12. Sales Compensation
RecipientRecipient CRD Number o None
  
(Associated) Broker or Dealer o None(Associated) Broker or Dealer CRD Number o None
  
Street Address 1Street Address 2
  
City State/Province/CountryZIP/Postal Code
   
State(s) of Solicitation o All States
 
 



13. Offering and Sales Amounts
Total Offering Amount $ 5960979 USD o Indefinite
Total Amount Sold $ 5160997 USD 
Total Remaining to be Sold $ 799982 USD o Indefinite
 
Clarification of Response (if Necessary)
  


14. Investors
x Select if securities in the offering have been or may be sold to persons who do not qualify as accredited investors,
Number of such non-accredited investors who already have invested in the offering
4
  Regardless of whether securities in the offering have been or may be sold to persons who do not qualify as accredited investors, enter the total number of investors who already have invested in the offering: 32


15. Sales Commissions & Finders’ Fees Expenses
Provide separately the amounts of sales commissions and finders' fees expenses, if any. If the amount of an expenditure is not known, provide an estimate and check the box next to the amount.
Sales Commissions$ 0 USD o Estimate
Finders' Fees$ 0 USD o Estimate
 
Clarification of Response (if Necessary)
  


16. Use of Proceeds
Provide the amount of the gross proceeds of the offering that has been or is proposed to be used for payments to any of the persons required to be named as executive officers, directors or promoters in response to Item 3 above. If the amount is unknown, provide an estimate and check the box next to the amount.
 $ 0 USD o
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