Amended Statement of Beneficial Ownership (sc 13d/a)
March 16 2021 - 6:06AM
Edgar (US Regulatory)
UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
SCHEDULE 13D
UNDER THE SECURITIES EXCHANGE ACT OF
1934
(Amendment No. 1)*
Vallon
Pharmaceuticals, Inc.
(Name of Issuer)
Common Stock
(Title of Class of Securities)
92023M101
(CUSIP Number)
SALMON Pharma GmbH
Richard Ammer, M.D., Ph.D.
Kuhloweg 37, D-58638
Iserlohn, Germany
Telephone: +49 2371 937-0
(Name, Address and Telephone Number of
Person Authorized to Receive Notices and Communications)
February 9, 2021
(Date of Event Which Requires Filing
of This Statement)
If the filing person has previously filed a statement on Schedule
13G to report the acquisition that is the subject of this Schedule 13D, and is filing this schedule because of §§240.13d-1(e),
240.13d-1(f) or 240.13d-1(g), check the following box. ¨
Note: Schedules filed in paper format shall include a
signed original and five copies of the schedule, including all exhibits. See §240.13d-7 for other parties to whom copies are
to be sent.
*
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The remainder of this cover page shall be filled out for a reporting person’s initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter disclosures provided in a prior cover page.
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The information required on the remainder of this cover page
shall not be deemed to be “filed” for the purpose of Section 18 of the Securities Exchange Act of 1934 (“Act”)
or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however,
see the Notes).
CUSIP No. 92023M101
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1.
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Name of Reporting Persons.
I.R.S. Identification No(s). of above person(s)
(entities only)
SALMON Pharma GmbH
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2.
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Check the Appropriate Box if a Member of a Group
(See Instructions)
(a) ¨ (b) ☐
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3.
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SEC USE ONLY
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4.
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Source of Funds (See Instructions)
WC
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5.
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Check if Disclosure of Legal Proceedings Is Required
Pursuant to Items 2(d) or 2(e)
¨
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6.
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Citizenship or Place of Organization
Switzerland
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Number of
Shares
Beneficially
Owned by
Each
Reporting
Person
With:
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7.
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Sole Voting Power
0
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8.
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Shared Voting Power
1,523,797
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9.
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Sole Dispositive Power
0
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10.
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Shared Dispositive Power
1,523,797
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11.
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Aggregate Amount Beneficially Owned by Each Reporting
Person
1,523,797
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12.
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Check if the Aggregate Amount in Row (11) Excludes
Certain Shares (See Instructions)
¨
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13.
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Percent of Class Represented by Amount in Row (11)
22.4% (1)
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14.
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Type of Reporting Person (See Instructions)
OO
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(1)
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This
percentage is calculated based upon 6,811,122 shares of the Issuer’s common stock outstanding upon completion of the
Issuer’s initial public offering (after giving effect to the conversion of certain convertible notes held by SALMON
Pharma GmbH and David Baker).
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CUSIP No. 92023M101
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1.
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Name of Reporting Persons.
I.R.S. Identification No(s). of above person(s)
(entities only)
Richard Ammer, M.D., Ph.D.
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2.
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Check the Appropriate Box if a Member of a Group
(See Instructions)
(a) ¨ (b) ☐
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3.
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SEC USE ONLY
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4.
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Source of Funds (See Instructions)
AF
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5.
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Check if Disclosure of Legal Proceedings Is Required
Pursuant to Items 2(d) or 2(e)
¨
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6.
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Citizenship or Place of Organization
Germany
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Number of
Shares
Beneficially
Owned by
Each
Reporting
Person
With:
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7.
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Sole Voting Power
0
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8.
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Shared Voting Power
1,523,797 (1)
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9.
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Sole Dispositive Power
0
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10.
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Shared Dispositive Power
1,523,797 (1)
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11.
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Aggregate Amount Beneficially Owned by Each Reporting
Person
1,523,797 (1)
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12.
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Check if the Aggregate Amount in Row (11) Excludes
Certain Shares (See Instructions)
¨
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13.
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Percent of Class Represented by Amount in Row (11)
22.4% (2)
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14.
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Type of Reporting Person (See Instructions)
IN
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(1)
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Represents shares of common stock held by SALMON
Pharma GmbH. Dr. Ammer is the general manager of SALMON Pharma GmbH.
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(2)
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This percentage is calculated based upon 6,811,122
shares of the Issuer’s common stock outstanding upon completion of the Issuer’s initial public offering (after
giving effect to the conversion of certain convertible notes held by SALMON Pharma GmbH and David Baker).
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Preliminary Note. Pursuant to Rule 13d-2 promulgated
under the Act, this amendment to Schedule 13D (this "Amendment No. 1") amends the Schedule 13D filed by SALMON Pharma
GmbH and Richard Ammer, M.D., Ph.D. (collectively, the "Reporting Person") on February 16, 2021 with respect to the Common
Stock, $0.0001 par value per share (the “Common Stock”), of Vallon Pharmaceuticals, Inc., a Delaware corporation (the
“Issuer”) (the "Original Schedule 13D"). The Original Schedule 13D and this Amendment No. 1 are collectively
referred to herein as the "Schedule 13D". Capitalized terms used but not defined in this Amendment No. 1 shall have the
meanings given to them in the Original Schedule 13D (as amended by Amendment No. 1). The Original Schedule 13D (as amended by Amendment
No. 1) remains in full force and effect, except as specifically amended by this Amendment No. 1. This Amendment No. 1 is being
filed solely to correct a scrivener’s error in connection with the percentage of outstanding shares of the Issuer's Common
Stock owned by the Reporting Person.
Item 5. Interest in Securities of the Issuer
(a) – (b) The following information with respect to the
ownership of the Common Stock of the Issuer by the Filing Persons is provided as of February 10, 2021:
Reporting
Person
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Securities Held
Directly
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Sole
Voting
Power
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Shared
Voting
Power
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Sole
Dispositive
Power
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Shared
Dispositive
Power
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Beneficial
Ownership
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Percentage
of Class
(1)
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SALMON
Pharma GmbH
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1,523,797
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0
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1,523,797
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0
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1,523,797
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1,523,797
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22.4
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%
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Richard
Ammer, M.D., Ph.D.(2)
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0
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0
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1,523,797
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0
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1,523,797
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1,523,797
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22.4
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%
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(1)
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This percentage is based upon 6,811,122 shares of the Issuer’s common stock outstanding upon completion of the Issuer’s initial public offering (after giving effect to the conversion of certain convertible notes held by SALMON and David Baker).
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(2)
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Represents 1,523,797 shares of common stock held by SALMON. Ammer is the general manager of SALMON.
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(c) The information provided in Item 3 is hereby incorporated
by reference. Except as otherwise set forth herein, the Filing Persons have not acquired or disposed of any securities of the Issuer
in the past 60 days.
(d) Inapplicable.
(e) Inapplicable.
Signatures
After reasonable inquiry and to the best of my knowledge and
belief, I certify that the information set forth in this statement is true, complete and correct.
Date: March 15, 2021
SALMON PHARMA GMBH
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By:
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/s/ Richard Ammer, M.D.,
Ph.D.
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Name:
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Richard Ammer, M.D., Ph.D.
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Title:
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General Manager
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By:
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/s/ Richard Ammer, M.D.,
Ph.D.
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Name:
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Richard Ammer, M.D., Ph.D.
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