<SEC-DOCUMENT>0001493152-22-001016.txt : 20220112
<SEC-HEADER>0001493152-22-001016.hdr.sgml : 20220112
<ACCEPTANCE-DATETIME>20220112092630
ACCESSION NUMBER:		0001493152-22-001016
CONFORMED SUBMISSION TYPE:	3
PUBLIC DOCUMENT COUNT:		1
CONFORMED PERIOD OF REPORT:	20220111
FILED AS OF DATE:		20220112
DATE AS OF CHANGE:		20220112

REPORTING-OWNER:	

	OWNER DATA:	
		COMPANY CONFORMED NAME:			MILBY RANDY
		CENTRAL INDEX KEY:			0001360968

	FILING VALUES:
		FORM TYPE:		3
		SEC ACT:		1934 Act
		SEC FILE NUMBER:	001-41210
		FILM NUMBER:		22525701

	MAIL ADDRESS:	
		STREET 1:		5 JACK LANE
		CITY:			NEWARK
		STATE:			DE
		ZIP:			19711

ISSUER:		

	COMPANY DATA:	
		COMPANY CONFORMED NAME:			Hillstream BioPharma Inc.
		CENTRAL INDEX KEY:			0001861657
		STANDARD INDUSTRIAL CLASSIFICATION:	PHARMACEUTICAL PREPARATIONS [2834]
		IRS NUMBER:				842642541
		STATE OF INCORPORATION:			DE
		FISCAL YEAR END:			1231

	BUSINESS ADDRESS:	
		STREET 1:		1200 ROUTE 22 EAST
		CITY:			BRIDGEWATER
		STATE:			NJ
		ZIP:			08807
		BUSINESS PHONE:		302-743-2995

	MAIL ADDRESS:	
		STREET 1:		245 MAIN STREET
		STREET 2:		SUITE 204
		CITY:			CHESTER
		STATE:			NJ
		ZIP:			07930
</SEC-HEADER>
<DOCUMENT>
<TYPE>3
<SEQUENCE>1
<FILENAME>ownership.xml
<TEXT>
<XML>
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    <schemaVersion>X0206</schemaVersion>

    <documentType>3</documentType>

    <periodOfReport>2022-01-11</periodOfReport>

    <noSecuritiesOwned>0</noSecuritiesOwned>

    <issuer>
        <issuerCik>0001861657</issuerCik>
        <issuerName>Hillstream BioPharma Inc.</issuerName>
        <issuerTradingSymbol>HILS</issuerTradingSymbol>
    </issuer>

    <reportingOwner>
        <reportingOwnerId>
            <rptOwnerCik>0001360968</rptOwnerCik>
            <rptOwnerName>MILBY RANDY</rptOwnerName>
        </reportingOwnerId>
        <reportingOwnerAddress>
            <rptOwnerStreet1>C/O HILLSTREAM BIOPHARMA, INC.</rptOwnerStreet1>
            <rptOwnerStreet2>1200 ROUTE 22 EAST, SUITE 2000</rptOwnerStreet2>
            <rptOwnerCity>BRIDGEWATER</rptOwnerCity>
            <rptOwnerState>NJ</rptOwnerState>
            <rptOwnerZipCode>08807</rptOwnerZipCode>
            <rptOwnerStateDescription></rptOwnerStateDescription>
        </reportingOwnerAddress>
        <reportingOwnerRelationship>
            <isDirector>1</isDirector>
            <isOfficer>1</isOfficer>
            <isTenPercentOwner>0</isTenPercentOwner>
            <isOther>0</isOther>
            <officerTitle>Chief Executive Officer</officerTitle>
            <otherText></otherText>
        </reportingOwnerRelationship>
    </reportingOwner>

    <derivativeTable>
        <derivativeHolding>
            <securityTitle>
                <value>Convertible Note</value>
            </securityTitle>
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            <underlyingSecurity>
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            <ownershipNature>
                <directOrIndirectOwnership>
                    <value>D</value>
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        <derivativeHolding>
            <securityTitle>
                <value>Convertible Note</value>
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            <conversionOrExercisePrice>
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            <exerciseDate>
                <footnoteId id="F7"/>
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            <expirationDate>
                <footnoteId id="F7"/>
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            <underlyingSecurity>
                <underlyingSecurityTitle>
                    <value>Common stock</value>
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                <underlyingSecurityShares>
                    <footnoteId id="F7"/>
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            <ownershipNature>
                <directOrIndirectOwnership>
                    <value>D</value>
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        <derivativeHolding>
            <securityTitle>
                <value>Convertible Note</value>
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            <conversionOrExercisePrice>
                <footnoteId id="F8"/>
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            <exerciseDate>
                <footnoteId id="F8"/>
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            <expirationDate>
                <footnoteId id="F8"/>
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            <underlyingSecurity>
                <underlyingSecurityTitle>
                    <value>Common stock</value>
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                <directOrIndirectOwnership>
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        <derivativeHolding>
            <securityTitle>
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            <underlyingSecurity>
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                <underlyingSecurityShares>
                    <footnoteId id="F9"/>
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            <ownershipNature>
                <directOrIndirectOwnership>
                    <value>D</value>
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        </derivativeHolding>
        <derivativeHolding>
            <securityTitle>
                <value>Convertible Note</value>
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            <conversionOrExercisePrice>
                <footnoteId id="F10"/>
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            <exerciseDate>
                <footnoteId id="F10"/>
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            <underlyingSecurity>
                <underlyingSecurityTitle>
                    <value>Common stock</value>
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                <underlyingSecurityShares>
                    <footnoteId id="F10"/>
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            <ownershipNature>
                <directOrIndirectOwnership>
                    <value>D</value>
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        </derivativeHolding>
        <derivativeHolding>
            <securityTitle>
                <value>Convertible Note</value>
            </securityTitle>
            <conversionOrExercisePrice>
                <footnoteId id="F11"/>
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            <exerciseDate>
                <footnoteId id="F11"/>
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            <expirationDate>
                <footnoteId id="F11"/>
            </expirationDate>
            <underlyingSecurity>
                <underlyingSecurityTitle>
                    <value>Common stock</value>
                </underlyingSecurityTitle>
                <underlyingSecurityShares>
                    <footnoteId id="F11"/>
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            <ownershipNature>
                <directOrIndirectOwnership>
                    <value>D</value>
                </directOrIndirectOwnership>
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        </derivativeHolding>
        <derivativeHolding>
            <securityTitle>
                <value>Convertible Note</value>
            </securityTitle>
            <conversionOrExercisePrice>
                <footnoteId id="F12"/>
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            <exerciseDate>
                <footnoteId id="F12"/>
            </exerciseDate>
            <expirationDate>
                <footnoteId id="F12"/>
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            <underlyingSecurity>
                <underlyingSecurityTitle>
                    <value>Common stock</value>
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                <underlyingSecurityShares>
                    <footnoteId id="F12"/>
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            <ownershipNature>
                <directOrIndirectOwnership>
                    <value>D</value>
                </directOrIndirectOwnership>
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        </derivativeHolding>
        <derivativeHolding>
            <securityTitle>
                <value>Convertible Note</value>
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            <conversionOrExercisePrice>
                <footnoteId id="F13"/>
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            <exerciseDate>
                <footnoteId id="F13"/>
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            <expirationDate>
                <footnoteId id="F13"/>
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            <underlyingSecurity>
                <underlyingSecurityTitle>
                    <value>Common stock</value>
                </underlyingSecurityTitle>
                <underlyingSecurityShares>
                    <footnoteId id="F13"/>
                </underlyingSecurityShares>
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            <ownershipNature>
                <directOrIndirectOwnership>
                    <value>D</value>
                </directOrIndirectOwnership>
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        </derivativeHolding>
        <derivativeHolding>
            <securityTitle>
                <value>Convertible Note</value>
            </securityTitle>
            <conversionOrExercisePrice>
                <footnoteId id="F14"/>
            </conversionOrExercisePrice>
            <exerciseDate>
                <footnoteId id="F14"/>
            </exerciseDate>
            <expirationDate>
                <footnoteId id="F14"/>
            </expirationDate>
            <underlyingSecurity>
                <underlyingSecurityTitle>
                    <value>Common stock</value>
                </underlyingSecurityTitle>
                <underlyingSecurityShares>
                    <footnoteId id="F14"/>
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            <ownershipNature>
                <directOrIndirectOwnership>
                    <value>D</value>
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        </derivativeHolding>
    </derivativeTable>

    <footnotes>
        <footnote id="F1">On April 19, 2021, the Registrant issued the Reporting Person a note in the principal amount of $25,000. The note matures upon the earlier of (i) April 19, 2024 and (ii) the closing of the Next Equity Financing (as defined therein). The principal amount of the note together with accrued interest thereon shall automatically convert into the type of Equity Securities (as defined therein) issued in the Next Equity Financing. The number of Equity Securities to be issued upon conversion of the note shall be equal to the quotient obtained by dividing the outstanding principal amount of the note together with interest accrued thereon by the lesser of (i) 80% of the price paid per Equity Security in the Next Equity Financing and (ii) an equity valuation of the Registrant of $50 million.</footnote>
        <footnote id="F2">On April 30, 2021, the Registrant issued the Reporting Person a note in the principal amount of $35,000. The note matures upon the earlier of (i) April 30, 2024 and (ii) the closing of the Next Equity Financing (as defined therein). The principal amount of the note together with accrued interest thereon shall automatically convert into the type of Equity Securities (as defined therein) issued in the Next Equity Financing. The number of Equity Securities to be issued upon conversion of the note shall be equal to the quotient obtained by dividing the outstanding principal amount of the note together with interest accrued thereon by the lesser of (i) 80% of the price paid per Equity Security in the Next Equity Financing and (ii) an equity valuation of the Registrant of $50 million.</footnote>
        <footnote id="F3">On May 10, 2021, the Registrant issued the Reporting Person a note in the principal amount of $10,000. The note matures upon the earlier of (i) May 10, 2024 and (ii) the closing of the Next Equity Financing (as defined therein). The principal amount of the note together with accrued interest thereon shall automatically convert into the type of Equity Securities (as defined therein) issued in the Next Equity Financing. The number of Equity Securities to be issued upon conversion of the note shall be equal to the quotient obtained by dividing the outstanding principal amount of the note together with interest accrued thereon by the lesser of (i) 80% of the price paid per Equity Security in the Next Equity Financing and (ii) an equity valuation of the Registrant of $50 million.</footnote>
        <footnote id="F4">On May 15, 2021, the Registrant issued the Reporting Person a note in the principal amount of $35,750. The note matures upon the earlier of (i) May 15, 2024 and (ii) the closing of the Next Equity Financing (as defined therein). The principal amount of the note together with accrued interest thereon shall automatically convert into the type of Equity Securities (as defined therein) issued in the Next Equity Financing. The number of Equity Securities to be issued upon conversion of the note shall be equal to the quotient obtained by dividing the outstanding principal amount of the note together with interest accrued thereon by the lesser of (i) 80% of the price paid per Equity Security in the Next Equity Financing and (ii) an equity valuation of the Registrant of $50 million.</footnote>
        <footnote id="F5">On May 25, 2021, the Registrant issued the Reporting Person a note in the principal amount of $90,000. The note matures upon the earlier of (i) May 25, 2024 and (ii) the closing of the Next Equity Financing (as defined therein). The principal amount of the note together with accrued interest thereon shall automatically convert into the type of Equity Securities (as defined therein) issued in the Next Equity Financing. The number of Equity Securities to be issued upon conversion of the note shall be equal to the quotient obtained by dividing the outstanding principal amount of the note together with interest accrued thereon by the lesser of (i) 80% of the price paid per Equity Security in the Next Equity Financing and (ii) an equity valuation of the Registrant of $50 million.</footnote>
        <footnote id="F6">On May 29, 2021, the Registrant issued the Reporting Person a note in the principal amount of $88,000. The note matures upon the earlier of (i) May 29, 2024 and (ii) the closing of the Next Equity Financing (as defined therein). The principal amount of the note together with accrued interest thereon shall automatically convert into the type of Equity Securities (as defined therein) issued in the Next Equity Financing. The number of Equity Securities to be issued upon conversion of the note shall be equal to the quotient obtained by dividing the outstanding principal amount of the note together with interest accrued thereon by the lesser of (i) 80% of the price paid per Equity Security in the Next Equity Financing and (ii) an equity valuation of the Registrant of $50 million.</footnote>
        <footnote id="F7">On June 14, 2021, the Registrant issued the Reporting Person a note in the principal amount of $59,990. The note matures upon the earlier of (i) June 14, 2024 and (ii) the closing of the Next Equity Financing (as defined therein). The principal amount of the note together with accrued interest thereon shall automatically convert into the type of Equity Securities (as defined therein) issued in the Next Equity Financing. The number of Equity Securities to be issued upon conversion of the note shall be equal to the quotient obtained by dividing the outstanding principal amount of the note together with interest accrued thereon by the lesser of (i) 80% of the price paid per Equity Security in the Next Equity Financing and (ii) an equity valuation of the Registrant of $50 million.</footnote>
        <footnote id="F8">On June 22, 2021, the Registrant issued the Reporting Person a note in the principal amount of $30,000. The note matures upon the earlier of (i) June 22, 2024 and (ii) the closing of the Next Equity Financing (as defined therein). The principal amount of the note together with accrued interest thereon shall automatically convert into the type of Equity Securities (as defined therein) issued in the Next Equity Financing. The number of Equity Securities to be issued upon conversion of the note shall be equal to the quotient obtained by dividing the outstanding principal amount of the note together with interest accrued thereon by the lesser of (i) 80% of the price paid per Equity Security in the Next Equity Financing and (ii) an equity valuation of the Registrant of $50 million.</footnote>
        <footnote id="F9">On July 16, 2021, the Registrant issued the Reporting Person a note in the principal amount of $70,000. The note matures upon the earlier of (i) July 17, 2024 and (ii) the closing of the Next Equity Financing (as defined therein). The principal amount of the note together with accrued interest thereon shall automatically convert into the type of Equity Securities (as defined therein) issued in the Next Equity Financing. The number of Equity Securities to be issued upon conversion of the note shall be equal to the quotient obtained by dividing the outstanding principal amount of the note together with interest accrued thereon by the lesser of (i) 80% of the price paid per Equity Security in the Next Equity Financing and (ii) an equity valuation of the Registrant of $50 million.</footnote>
        <footnote id="F10">On July 28, 2021, the Registrant issued the Reporting Person a note in the principal amount of $110,000. The note matures upon the earlier of (i) July 28, 2024 and (ii) the closing of the Next Equity Financing (as defined therein). The principal amount of the note together with accrued interest thereon shall automatically convert into the type of Equity Securities (as defined therein) issued in the Next Equity Financing. The number of Equity Securities to be issued upon conversion of the note shall be equal to the quotient obtained by dividing the outstanding principal amount of the note together with interest accrued thereon by the lesser of (i) 80% of the price paid per Equity Security in the Next Equity Financing and (ii) an equity valuation of the Registrant of $50 million.</footnote>
        <footnote id="F11">On August 13, 2021, the Registrant issued the Reporting Person a note in the principal amount of $82,500. The note matures upon the earlier of (i) August 13, 2024 and (ii) the closing of the Next Equity Financing (as defined therein). The principal amount of the note together with accrued interest thereon shall automatically convert into the type of Equity Securities (as defined therein) issued in the Next Equity Financing. The number of Equity Securities to be issued upon conversion of the note shall be equal to the quotient obtained by dividing the outstanding principal amount of the note together with interest accrued thereon by the lesser of (i) 80% of the price paid per Equity Security in the Next Equity Financing and (ii) an equity valuation of the Registrant of $50 million.</footnote>
        <footnote id="F12">On October 14, 2021, the Registrant issued the Reporting Person a note in the principal amount of $30,250. The note matures upon the earlier of (i) October 14, 2024 and (ii) the closing of the Next Equity Financing (as defined therein). The principal amount of the note together with accrued interest thereon shall automatically convert into the type of Equity Securities (as defined therein) issued in the Next Equity Financing. The number of Equity Securities to be issued upon conversion of the note shall be equal to the quotient obtained by dividing the outstanding principal amount of the note together with interest accrued thereon by the lesser of (i) 80% of the price paid per Equity Security in the Next Equity Financing and (ii) an equity valuation of the Registrant of $50 million.</footnote>
        <footnote id="F13">On November 12, 2021, the Registrant issued the Reporting Person a note in the principal amount of $99,000. The note matures upon the earlier of (i) November 12, 2024 and (ii) the closing of the Next Equity Financing (as defined therein). The principal amount of the note together with accrued interest thereon shall automatically convert into the type of Equity Securities (as defined therein) issued in the Next Equity Financing. The number of Equity Securities to be issued upon conversion of the note shall be equal to the quotient obtained by dividing the outstanding principal amount of the note together with interest accrued thereon by the lesser of (i) 80% of the price paid per Equity Security in the Next Equity Financing and (ii) an equity valuation of the Registrant of $50 million.</footnote>
        <footnote id="F14">On December 15, 2021, the Registrant issued the Reporting Person a note in the principal amount of $99,000. The note matures upon the earlier of (i) December 15, 2024 and (ii) the closing of the Next Equity Financing (as defined therein). The principal amount of the note together with accrued interest thereon shall automatically convert into the type of Equity Securities (as defined therein) issued in the Next Equity Financing. The number of Equity Securities to be issued upon conversion of the note shall be equal to the quotient obtained by dividing the outstanding principal amount of the note together with interest accrued thereon by the lesser of (i) 80% of the price paid per Equity Security in the Next Equity Financing and (ii) an equity valuation of the Registrant of $50 million.</footnote>
    </footnotes>

    <remarks>This is the third of the three Form 3s.</remarks>

    <ownerSignature>
        <signatureName>/s/ Randy Milby</signatureName>
        <signatureDate>2022-01-12</signatureDate>
    </ownerSignature>
</ownershipDocument>
</XML>
</TEXT>
</DOCUMENT>
</SEC-DOCUMENT>
