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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 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. | |||
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. | SEC 1474 (9-02) |
1. Title of Derivative Security (Instr. 3) |
2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction 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 (Month/Day/Year) |
7. Title and Amount of Underlying Securities (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) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Stock Option (right to buy) | $ 0.145 | 12/31/2010 | A(1) | 1,000,000 | (1) | 12/09/2015 | Common Stock | 1,000,000 | $ 0 | 1,000,000 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
BERGER STEVEN C 850 THIRD AVENUE SUITE 1801 NEW YORK, NY 10022 |
CFO, Treasurer and Secretary |
/s/ Steven C. Berger | 01/04/2011 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 4(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). |
(1) | Represents stock options granted to Steven C. Berger pursuant to the Alliqua, Inc. (the "Company") 2001 Incentive Stock Plan on December 9, 2010 and accepted by Mr. Berger on December 31, 2010. These shares vest as follows: (i) 500,000 of the options granted vested immediately, (ii) 250,000 of the options vested on January 3, 2011 upon the creation of a Board of Directors of the Company that fully complied with the Corporate Governance Requirements set forth in Sections 801-809 of the NYSE Amex Rules, and (iii) 250,000 of the options shall vest only upon the filing of the Company's Annual Report on Form 10-K with the Securities and Exchange Commission for the fiscal year ending December 31, 2010 without any material weaknesses in the Company's financial reporting under the Sarbanes-Oxley Act of 2002. |