UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES 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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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | SEC 1473 (7-02) | ||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. |
1. Title of Derivative Security (Instr. 4) |
2. Date Exercisable and Expiration Date (Month/Day/Year) |
3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) |
4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 5) |
6. Nature of Indirect Beneficial Ownership (Instr. 5) |
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Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Adynxx, Inc. 100 PINE STREET, SUITE 500 SAN FRANCISCO, CA 94111 |
X |
/s/ Rick Orr, President and Chief Executive Officer | 06/21/2019 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 5(b)(v). |
** | Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
Remarks: This Form 3 is being filed by Adynxx, Inc. (formerly Alliqua BioMedical, Inc.) (the "Company") in connection with the registration of the common stock of AquaMed Technologies, Inc. ("AquaMed") with the Securities and Exchange Commission (the "SEC") under Section 12(g) of the Securities Exchange Act of 1934, as amended, pursuant to a Registration Statement on Form 10 filed by AquaMed and declared effective by the SEC. AquaMed is currently a direct wholly-owned subsidiary of the Company. On June 21, 2019, in connection with the registration of AquaMed common stock with the SEC, the Company will effect its previously announced distribution of all of the outstanding shares of common stock of AquaMed. |