R
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ANNUAL REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
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£
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TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
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Florida
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58-2349413
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(State or other jurisdiction of incorporation)
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(I.R.S. Employer Identification Number)
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850 Third Avenue Suite 1801
New York, NY
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10022
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(Address of principal executive office)
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(Zip Code)
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Title of each Class:
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COMMON STOCK, PAR VALUE $0.001 PER SHARE
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Person or Group
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Number of Shares of
Common Stock
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Percent
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David Stefansky
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39,461,165 (1)
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19.1%
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850 Third Avenue, Suite 1801
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New York, NY 10022
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Richard Rosenblum
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39,461,165 (2)
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19.1%
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850 Third Avenue, Suite 1801
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New York, NY 10022
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Steven Berger
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750,000 (3)
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<1%
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850 Third Avenue, Suite 1801
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New York, NY 10022
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Joseph Sierchio
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370,000 (4)
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<1%
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850 Third Avenue, Suite 1801
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New York, NY 10022
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Joseph M. Leone
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250,000 (5)
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<1%
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850 Third Avenue, Suite 1801
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New York, NY 10022
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Kenneth D. Pearson
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250,000 (5)
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<1%
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850 Third Avenue, Suite 1801
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New York, NY 10022
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Jeffrey Sklar
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250,000 (5)
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<1%
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850 Third Avenue, Suite 1801
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New York, NY 10022
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Nachum Stein
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250,000 (5)
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<1%
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850 Third Avenue, Suite 1801
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New York, NY 10022
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Michael Goldberg
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250,000 (5)
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<1%
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850 Third Avenue, Suite 1801
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New York, NY 10022
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Amit Dang
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100,000 (5)
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<1%
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60 State Street, Suite 700
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Boston, MA 02109
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1420525 Alberta Ltd.
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34,261,174 (6)
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16.6%
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216-1628 West First Avenue
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Vancouver, B.C.
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V6J 1G1 Canada
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Directors and Executive Officers as a group (9 persons)
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45,597,832
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22.1%
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(1)
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Comprised of (i) 35,794,498 shares of our Common Stock owned directly by Harborview Master Fund, L.P. and Harborview Value Master Fund, L.P. and (ii) 3,666,667 shares of our Common Stock issuable to Mr. Stefansky upon exercise of the vested portion of certain stock options. Harborview Advisors, LLC is the general partner of Harborview Master Fund, L.P. and Harborview Value Master Fund, L.P. and has sole voting and dispositive power over the securities. Richard Rosenblum and David Stefansky are the managing members of Harborview Advisors, LLC and disclaim beneficial ownership of the reported securities, except to the extent of any pecuniary interest in the securities.
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(2)
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Comprised of (i) 35,794,498 shares of our Common Stock owned directly by Harborview Master Fund, L.P. and Harborview Value Master Fund, L.P. and (ii) 3,666,667 shares of our Common Stock issuable to Mr. Rosenblum upon exercise of the vested portion of certain stock options. Harborview Advisors, LLC is the general partner of Harborview Master Fund, L.P. and Harborview Value Master Fund, L.P. and has sole voting and dispositive power over the securities. Richard Rosenblum and David Stefansky are the managing members of Harborview Advisors, LLC and disclaim beneficial ownership of the reported securities, except to the extent of any pecuniary interest in the securities.
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(3)
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Represents shares issuable upon exercise of vested options.
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(4)
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This amount includes 270,000 shares of Common Stock issuable upon exercise of vested options.
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(5)
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Represents shares issuable upon exercise of vested options.
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(6)
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This amount includes 31,057,980 shares of Common Stock held by 1420525 Alberta Ltd. (“1420525”), a private Alberta company wholly-owned by Harmel Rayat, and 3,203,194 shares of Common Stock held by Tajinder Chohan, Mr. Rayat’s wife. In his capacity as President and the sole stockholder of 1420525, Mr. Rayat may be deemed to have beneficial ownership of the Common Stock owned by 1420525.
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EXHIBIT
NUMBER
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DESCRIPTION
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31.1*
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Certification of Principal Executive Officer and Principal Financial Officer Pursuant to Rule 13a-14 of the Securities Exchange Act of 1934, As Adopted Pursuant to Section 302 of the Sarbanes-Oxley Act of 2002 to the Form10-K, File No. 000-29819.
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32.1*
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Certification of Principal Executive Officer and Principal Financial Officer Pursuant to 18 USC. Section 1350, As Adopted Pursuant to Section 906 of the Sarbanes-Oxley Act of 2002 to the Form10-K, File No. 000-29819
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Alliqua, Inc.
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May 12, 2011
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By:
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/s/ Richard Rosenblum
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Richard Rosenblum
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President
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(Principal Executive Officer)
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/s/ Steven Berger
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Steven Berger
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Chief Financial Officer, Treasurer and Secretary
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(Principal Financial and Accounting Officer)
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