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Home/Filings/4/0001213900-18-010087
4//SEC Filing

En Fidecomiso de Mi Vida 11/23/2010 Trust 4

Accession 0001213900-18-010087

CIK 0001513525other
View on SEC.govCompany Profile

Filed

Aug 1, 8:00 PM ET

Accepted

Aug 2, 4:08 PM ET

Size

30.9 KB

Accession

0001213900-18-010087

Insider Transaction Report

Form 4
Period: 2018-07-31
ADIAL PHARMACEUTICALS, INC.ADIL
Johnson Bankole A.
Director10% Owner
Transactions
  • Purchase

    Common Stock

    2018-07-31+1,400→ 1,400 total
  • Award

    Common Stock

    2018-07-31+40,382→ 313,750 total(indirect: By LLC)
  • Conversion

    Convertible Note

    2018-07-31$0.44/sh−153,114$67,370→ 0 total
    Exercise: $0.44→ Common Stock (153,114 underlying)
  • Other

    Common Stock

    2018-07-31+17,600→ 273,368 total
  • Other

    Warrant to purchase common stock

    2018-07-31+17,600→ 17,600 total
    Exercise: $6.25From: 2018-07-31Exp: 2023-07-31→ Common Stock (17,600 underlying)
  • Other

    Warrant to purchase units

    2018-07-31+17,600→ 17,600 total
    Exercise: $5.00From: 2018-07-31Exp: 2023-07-31→ Units (35,200 underlying)
  • Conversion

    Warrant to purchase common stock

    2018-07-31+153,114→ 170,714 total
    Exercise: $6.25→ Common Stock (153,114 underlying)
  • Purchase

    Warrant to purchase common stock

    2018-07-31+1,400→ 169,314 total
    Exercise: $6.25From: 2018-07-31Exp: 2023-07-31→ Common Stock (1,400 underlying)
  • Conversion

    Common Stock

    2018-07-31$0.44/sh+153,114$67,370→ 255,768 total
Holdings

  • Common Stock

    (indirect: By Trust)
    7,440

  • Common Stock

    (indirect: Lina Tiouririne)
    930

  • Common Stock

    (indirect: By Trust)
    850,896

  • Common Stock

    (indirect: By Trust)
    93,000

  • Common Stock

    (indirect: By Trust)
    22,320

  • Common Stock

    (indirect: Ade Johnson)
    1,395

  • Common Stock

    (indirect: Lola Johnson)
    1,395

  • Common Stock

    (indirect: Aida Tiouririne)
    930

  • Common Stock

    (indirect: Efunbowale Johnson)
    4,650
En Fidecomiso de Mi Vida 11/23/2010 Trust
10% Owner
Transactions
  • Other

    Common Stock

    2018-07-31+17,600→ 273,368 total
  • Award

    Common Stock

    2018-07-31+40,382→ 313,750 total(indirect: By LLC)
  • Conversion

    Convertible Note

    2018-07-31$0.44/sh−153,114$67,370→ 0 total
    Exercise: $0.44→ Common Stock (153,114 underlying)
  • Purchase

    Warrant to purchase common stock

    2018-07-31+1,400→ 169,314 total
    Exercise: $6.25From: 2018-07-31Exp: 2023-07-31→ Common Stock (1,400 underlying)
  • Purchase

    Common Stock

    2018-07-31+1,400→ 1,400 total
  • Conversion

    Warrant to purchase common stock

    2018-07-31+153,114→ 170,714 total
    Exercise: $6.25→ Common Stock (153,114 underlying)
  • Conversion

    Common Stock

    2018-07-31$0.44/sh+153,114$67,370→ 255,768 total
  • Other

    Warrant to purchase common stock

    2018-07-31+17,600→ 17,600 total
    Exercise: $6.25From: 2018-07-31Exp: 2023-07-31→ Common Stock (17,600 underlying)
  • Other

    Warrant to purchase units

    2018-07-31+17,600→ 17,600 total
    Exercise: $5.00From: 2018-07-31Exp: 2023-07-31→ Units (35,200 underlying)
Holdings

  • Common Stock

    (indirect: By Trust)
    850,896

  • Common Stock

    (indirect: By Trust)
    93,000

  • Common Stock

    (indirect: By Trust)
    22,320

  • Common Stock

    (indirect: Efunbowale Johnson)
    4,650

  • Common Stock

    (indirect: Lina Tiouririne)
    930

  • Common Stock

    (indirect: Lola Johnson)
    1,395

  • Common Stock

    (indirect: Aida Tiouririne)
    930

  • Common Stock

    (indirect: By Trust)
    7,440

  • Common Stock

    (indirect: Ade Johnson)
    1,395
Footnotes (9)
  • [F1]The 153,114 shares of common stock and a warrant to purchase 153,114 shares of common stock were issued upon automatic conversion of a convertible note in the principal amount of $52,000 together with interest accrued thereon at a conversion price of $0.44 per share upon consummation of the initial public offering on July 31, 2018.
  • [F2]The 17,600 shares were received upon consummation of the initial public offering in accordance with a Securities Purchase Agreement dated February 22, 2018.
  • [F3]On July 31, 2018, Dr. Johnson purchased 1,400 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.
  • [F4]The 40,382 shares were received upon consummation of the initial public offering in accordance with a Services Agreement with Medico-Trans Company, LLC.
  • [F5]Medico-Trans Company, LLC is controlled by Bankole Johnson.
  • [F6]Dr. Johnson is the trustee of each of these trusts.
  • [F7]Dr. Johnson has a voting proxy on this person's behalf that entitles him to vote these shares.
  • [F8]A warrant to purchase 17,600 shares of common stock was issued upon consummation of the initial public offering in accordance with a Securities Purchase Agreement dated February 22, 2018.
  • [F9]The warrant to purchase 17,600 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 35,200 shares.

Documents

1 file

Issuer

ADIAL PHARMACEUTICALS, INC.

CIK 0001513525

→
Entity typeother

Related Parties

1
  • filerCIK 0001719033

Filing Metadata

Form type
4
Filed
Aug 1, 8:00 PM ET
Accepted
Aug 2, 4:08 PM ET
Size
30.9 KB
View on SEC.gov