Filing Details

Accession Number:
0001354488-12-005797
Form Type:
4
Zero Holdings:
No
Publication Time:
2012-11-13 19:39:25
Reporting Period:
2012-11-08
Filing Date:
2012-11-13
Accepted Time:
2012-11-13 19:39:25
SEC Url:
Form 4 Filing
Issuer
Cik Name Symbol Sector (SIC) IRS No
1054274 Alliqua Inc. ALQA Surgical & Medical Instruments & Apparatus (3841) 582349413
Insiders
Cik Name Reported Address Insider Title Director Officer Large Shareholder Other
1205074 Richard Rosenblum 19 Horizon Drive
Wayne NJ 07470
No No No Yes
1320581 David Stefansky 850 Third Avenue, Suite 1801
New York NY 10022
No No No Yes
1400704 Harborview Master Fund Lp Harbour House Waterford Drive
Po Box 972
Tortola D8 00000
No No No Yes
1492019 Harborview Advisors, Llc 850 Third Avenue, Suite 1801
New York NY 10022
- Yes Yes Yes No
1492020 Harborview Capital Management, Llc 850 Third Avenue, Suite 1801
New York NY 10022
No No No Yes
1509151 Harborview Value Master Fund, L.p. 850 Third Avenue, Suite 1801
New York NY 10022
No No No Yes
Reported Non-Derivative Transactions
Sec. Name Acquisiton - Disposition Date Amount Price Remaning Holdings Equity Swap Involved Form Type Code Nature of Ownership Explanation
Common Stock Acquisiton 2012-11-08 2,500,000 $0.00 24,879,728 No 4 P Indirect See Footnotes
Common Stock Acquisiton 2012-11-08 1,000,000 $0.00 25,879,728 No 4 P Indirect See Footnotes
Equity Swap Involved Form Type Code Nature of Ownership Explanation
No 4 P Indirect See Footnotes
No 4 P Indirect See Footnotes
Reported Derivative Transactions
Sec. Name Sec. Type Acquisiton - Disposition Date Amount Price Amount - 2 Price - 2
Common Stock Common Stock Warrants (right to buy) Acquisiton 2012-11-08 2,500,000 $0.00 2,500,000 $0.05
Common Stock Common Stock Warrants (right to buy) Acquisiton 2012-11-08 1,000,000 $0.00 1,000,000 $0.05
Remaning Holdings Exercise Date Expiration Date Equity Swap Involved Transaction Form Type Transaction Code Nature of Ownership
2,500,000 2012-11-08 2017-11-08 No 4 A Indirect
3,500,000 2012-11-08 2017-11-08 No 4 A Indirect
Footnotes
  1. This statement is jointly filed by and on behalf of each of Harborview Master Fund, L.P. ("Harborview Master Fund"), Harborview Value Master Fund, L.P. ("Harborview Value Fund"), Harborview Advisors, LLC ("Harborview Advisors"), Harborview Capital Management, LLC ("Harborview Management"), Richard Rosenblum and David Stefansky. Harborview Master Fund, Harborview Value Fund, Harborview Management and Messrs. Rosenblum and Stefansky are the record and direct beneficial owners of the securities covered by this statement. Harborview Advisors is the general partner of, and may be deemed to beneficially own securities owned by, each of Harborview Master Fund and Harborview Value Fund. Messrs. Rosenblum and Stefansky are the managing members of, and may be deemed to beneficially own securities owned by, each of Harborview Advisors and Harborview Management.
  2. Each reporting person states that neither the filing of this statement nor anything herein shall be deemed an admission that such person is, for purposes of Section 16 of the Securities Exchange Act of 1934, as amended (the "Act") or otherwise, the beneficial owner of any securities covered by this statement. Each reporting person disclaims beneficial ownership of the securities covered by this statement, except to the extent of the pecuniary interest of such person in such securities.
  3. Each reporting person may be deemed to be a member of a group with respect to the issuer or securities of the issuer for purposes of Section 13(d) or 13(g) of the Act. Each reporting person declares that neither the filing of this statement nor anything herein shall be construed as an admission that such person is, for the purposes of Section 13(d) or 13(g) of the Act or any other purpose, a member of a group with respect to the issuer or securities of the issuer.
  4. Includes, prior to the acquisitions reported on this Form 4, (a) 13,227,394 shares of common stock directly beneficially owned by Harborview Value Fund, (b) 2,310,000 shares of common stock directly beneficially owned by Harborview Management, (c) 3,028,571 shares of common stock directly beneficially owned by Mr. Rosenblum and (d) 3,813,763 shares of common stock directly beneficially owned by Mr. Stefansky.
  5. Mr. Stefansky purchased, as part of a private placement transaction on November 8, 2012, 2,500,000 units at a price per unit of $0.05, with each unit consisting of 1 share of common stock and a warrant to purchase 1 share of common stock.
  6. Harborview Value Fund purchased, as part of a private placement transaction on November 8, 2012, 1,000,000 units at a price per unit of $0.05, with each unit consisting of 1 share of common stock and a warrant to purchase 1 share of common stock.