x NoneEntity Type
0001751912
 
x Corporation
o Limited Partnership
o Limited Liability Company
o General Partnership
o Business Trust
o Other
Name of Issuer
 NERVGEN PHARMA CORP.
Jurisdiction of Incorporation/OrganizationBRITISH COLUMBIA, CANADA 
Year of Incorporation/Organization
  o Over Five Years Ago
  x Within Last Five Years (Specify Year) 2017
  o Yet to Be Formed 



2. Principal Place of Business and Contact Information
Name of Issuer 
 NERVGEN PHARMA CORP. 
Street Address 1Street Address 2
 SUITE 1703 - 595 BURRARD STREET 
CityState/Province/CountryZIP/Postal CodePhone No. of Issuer
 VANCOUVER BRITISH COLUMBIA, CANADA V7X 1J1 (604) 488-5421 



3. Related Persons
Last NameFirst NameMiddle Name
RadvakBill
Street Address 1Street Address 2
Suite 1703 - 595 Burrard Street
CityState/Province/CountryZIP/Postal Code
VancouverBRITISH COLUMBIA, CANADAV7X 1J1
Relationship: o Executive Officer x Director o Promoter
Clarification of Response (if Necessary)
 

Last NameFirst NameMiddle Name
BayleyBrian
Street Address 1Street Address 2
Suite 1703 - 595 Burrard Street
CityState/Province/CountryZIP/Postal Code
VancouverBRITISH COLUMBIA, CANADAV7X 1J1
Relationship: o Executive Officer x Director o Promoter
Clarification of Response (if Necessary)
 

Last NameFirst NameMiddle Name
AbramsMichael
Street Address 1Street Address 2
Suite 1703 - 595 Burrard Street
CityState/Province/CountryZIP/Postal Code
VanouverBRITISH COLUMBIA, CANADAV7X 1J1
Relationship: o Executive Officer x Director o Promoter
Clarification of Response (if Necessary)
 

Last NameFirst NameMiddle Name
PunnettHarold
Street Address 1Street Address 2
Suite 1703 - 595 Burrard Street
CityState/Province/CountryZIP/Postal Code
VancouverBRITISH COLUMBIA, CANADAV7X 1J1
Relationship: o Executive Officer x Director o Promoter
Clarification of Response (if Necessary)
 

 
Last NameFirst NameMiddle Name
BrennanPaul
Street Address 1Street Address 2
Suite 1703 - 595 Burrard Street
CityState/Province/CountryZIP/Postal Code
VancouverBRITISH COLUMBIA, CANADAV7X 1J1
Relationship: x Executive Officer x Director o Promoter
Clarification of Response (if Necessary)
 

Last NameFirst NameMiddle Name
KayeRandall
Street Address 1Street Address 2
Suite 1703 - 595 Burrard Street
CityState/Province/CountryZIP/Postal Code
VancouverBRITISH COLUMBIA, CANADAV7X 1J1
Relationship: o Executive Officer x Director o Promoter
Clarification of Response (if Necessary)
 

Last NameFirst NameMiddle Name
AdamsWilliam
Street Address 1Street Address 2
Suite 1703 - 595 Burrard Street
CityState/Province/CountryZIP/Postal Code
VancouverBRITISH COLUMBIA, CANADAV7X 1J1
Relationship: x Executive Officer o Director o Promoter
Clarification of Response (if Necessary)
 

Last NameFirst NameMiddle Name
MikolDaniel
Street Address 1Street Address 2
Suite 1703 - 595 Burrard Street
CityState/Province/CountryZIP/Postal Code
VancouverBRITISH COLUMBIA, CANADAV7X 1J1
Relationship: x Executive Officer o Director o Promoter
Clarification of Response (if Necessary)
 

 


4. Industry Group
o Agriculture Health Care o Retailing
 Banking & Financial Services   o Biotechnology o Restaurants
  o Commercial Banking   o Health Insurance Technology
  o Insurance  o Hospitals & Physicians  o Computers
  o Investing  o Pharmaceuticals  o Telecommunications
  o Investment Banking  o Other Health Care  o Other Technology
  o Pooled Investment Fund

    Travel
  o Other Banking & Financial Services o Manufacturing  o Airlines & Airports
 Real Estate  o Lodging & Conventions
  o Commercial  o Tourism & Travel Services
  o Construction  o Other Travel
  o REITS & Finance x Other
  o Residential 
  o Other Real Estate 
o Business Services 
 Energy 
  o Coal Mining 
  o Electric Utilities 
  o Energy Conservation 
  o Environmental Services 
  o Oil & Gas 
  o Other Energy 


5. Issuer Size
Revenue RangeAggregate Net Asset Value Range
o No Revenues o No Aggregate Net Asset Value
o $1 - $1,000,000 o $1 - $5,000,000
o $1,000,001 - $5,000,000 o $5,000,001 - $25,000,000
o $5,000,001 - $25,000,000 o $25,000,001 - $50,000,000
o $25,000,001 - $100,000,000 o $50,000,001 - $100,000,000
o Over $100,000,000 o Over $100,000,000
x Decline to Disclose o Decline to Disclose
o Not Applicable o Not Applicable


6. Federal Exemption(s) and Exclusion(s) Claimed (select all that apply)
o Rule 504(b)(1) (not (i), (ii) or (iii)) o Rule 505
o Rule 504 (b)(1)(i) x Rule 506(b)
o Rule 504 (b)(1)(ii) o Rule 506(c)
o Rule 504 (b)(1)(iii) o Securities Act Section 4(a)(5)
  o Investment Company Act Section 3(c)

7. Type of Filing
x New Notice Date of First Sale 2021-08-04 o First Sale Yet to Occur
o Amendment

8. Duration of Offering
Does the Issuer intend this offering to last more than one year? x Yes o No

9. Type(s) of Securities Offered (select all that apply)
o Pooled Investment Fund Interests x Equity
o Tenant-in-Common Securities o Debt
o Mineral Property Securities x Option, Warrant or Other Right to Acquire Another Security
o Security to be Acquired Upon Exercise of Option, Warrant or Other Right to Acquire Security x Other (describe)
 Unit offering; each Unit consists of one common share and one-half common share purchase warrant, each whole warrant exercisable at CAD$2.10 for 24 months


10. Business Combination Transaction
Is this offering being made in connection with a business combination transaction, such as a merger, acquisition or exchange offer? o Yes x No
 
Clarification of Response (if Necessary) 
  

11. Minimum Investment
Minimum investment accepted from any outside investor$ 0 USD

12. Sales Compensation
RecipientRecipient CRD Number o None
  
(Associated) Broker or Dealer o None(Associated) Broker or Dealer CRD Number o None
  
Street Address 1Street Address 2
  
City State/Province/CountryZIP/Postal Code
   
State(s) of Solicitation o All States
 
 



13. Offering and Sales Amounts
Total Offering Amount $ 442322 USD o Indefinite
Total Amount Sold $ 263692 USD 
Total Remaining to be Sold $ 178630 USD o Indefinite
 
Clarification of Response (if Necessary)
 Total amount remaining to be sold represents the maximum potential exercise price of warrants. Subscriptions paid in Canadian currency converted to US dollars at CAD$1.2497 = USD$1.00.


14. Investors
o Select if securities in the offering have been or may be sold to persons who do not qualify as accredited investors,
Number of such non-accredited investors who already have invested in the offering
 
  Regardless of whether securities in the offering have been or may be sold to persons who do not qualify as accredited investors, enter the total number of investors who already have invested in the offering: 3


15. Sales Commissions & Finders’ Fees Expenses
Provide separately the amounts of sales commissions and finders' fees expenses, if any. If the amount of an expenditure is not known, provide an estimate and check the box next to the amount.
Sales Commissions$ 0 USD o Estimate
Finders' Fees$ 0 USD o Estimate
 
Clarification of Response (if Necessary)
  


16. Use of Proceeds
Provide the amount of the gross proceeds of the offering that has been or is proposed to be used for payments to any of the persons required to be named as executive officers, directors or promoters in response to Item 3 above. If the amount is unknown, provide an estimate and check the box next to the amount.
 $ 0 USD o
NervGen Pharma (QB) (USOTC:NGENF)
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