Rubin Gary D 的 Form 4 申報
bioAffinity Technologies, Inc.（BIAF），2022/10/21 申報
- 申報編號
- 0001493152-22-029376
- 申報時間
- 2022/10/21 18:50 ET
- 交易日
- 2022/7/20-9/6
- 申報延遲
- 93 天遲報
- 10b5-1 計畫
- 表單沒有這欄（2023 年以前）
這份申報列了 8 筆非衍生性交易、13 筆衍生性交易。交易後 93 天才申報，超過 2 個營業日的期限。
申報人
一份 Form 4 可以有好幾位申報人，例如本人與他控制的基金。各交易表上顯示的是第一位。
| 申報人 | 與公司的關係 |
|---|---|
| Rubin Gary DCIK 0001947569 | 董事、持股 10% 以上大股東 |
| Harvey Sandler Revocable TrustCIK 0001323253 | 持股 10% 以上大股東 |
非衍生性證券（表 I）
普通股等股票的取得與處分，每一列是申報上的一筆。
| 交易日 | 證券 | 交易 | 股數 | 價格 | 金額 | 交易後持股 | 持有方式 | 旗標 |
|---|---|---|---|---|---|---|---|---|
| 2022/9/6 | Common Stock | C轉換取得 | +15,876 | $4.20F4 | +$66,679.2 | 51,590 | 直接 | |
| 2022/9/6 | Common Stock | C轉換取得 | +266,850 | $4.20F5 | +$1,120,770 | 1,082,866 | 間接 | |
| 2022/9/6 | Common Stock | C轉換取得 | +38,287 | $4.20F6 | +$160,805.4 | 1,121,153 | 間接 | |
| 2022/9/6 | Common Stock | C轉換取得 | +93,821 | $4.20F7 | +$394,048.2 | 1,214,974 | 間接 | |
| 2022/9/6 | Common Stock | C轉換取得 | +63,958 | $4.20F8 | +$268,623.6 | 1,278,932 | 間接 | |
| 2022/9/6 | Common Stock | C轉換取得 | +58,577 | $4.20F9 | +$246,023.4 | 1,337,509 | 間接 | |
| 2022/9/6 | Common Stock | C轉換取得 | +230,309 | $5.17F10 | +$1,190,697.53 | 1,567,818 | 間接 | |
| 2022/8/31 | Common Stock | P買進取得 | +16,326 | –F11 | – | 1,584,144 | 間接 |
衍生性證券（表 II）
選擇權、認股權證、限制型股票單位等。股數是標的股票的股數；單價與金額是衍生證券本身的價格，交易後持有是衍生證券的單位數。
| 交易日 | 證券 | 交易 | 標的股數 | 單價 | 金額 | 交易後持有 | 持有方式 | 旗標 |
|---|---|---|---|---|---|---|---|---|
| 2022/9/6 | Common Stock | C轉換處分 | −15,876 | $0.00 | – | 0 | 直接 | |
| 2022/9/6 | Common Stock | C轉換處分 | −266,850 | $0.00 | – | 0 | 間接 | |
| 2022/9/6 | Common Stock | C轉換處分 | −38,287 | $0.00 | – | 0 | 間接 | |
| 2022/9/6 | Common Stock | C轉換處分 | −93,821 | $0.00 | – | 0 | 間接 | |
| 2022/9/6 | Common Stock | C轉換處分 | −63,958 | $0.00 | – | 0 | 間接 | |
| 2022/9/6 | Common Stock | C轉換處分 | −58,577 | $0.00 | – | 0 | 間接 | |
| 2022/9/6 | Common Stock | C轉換處分 | −230,309 | $0.00 | $0 | 0 | 間接 | |
| 2022/8/31 | Common Stock | P買進取得 | +16,326 | –F11 | – | 16,326 | 間接 | |
| 2022/8/31 | Common Stock | P買進取得 | +16,326 | –F11 | – | 16,326 | 間接 | |
| 2022/9/6 | Common Stock | A公司授予取得 | +12,241 | –F12 | – | 12,241 | 直接 | |
| 2022/9/6 | Common Stock | P買進取得 | +408,125 | –F13 | – | 408,125 | 間接 | |
| 2022/7/20 | Common Stock | A公司授予取得 | +4,896 | –F14 | – | 4,896 | 直接 | |
| 2022/7/20 | Common Stock | P買進取得 | +163,248 | –F15 | – | 163,248 | 間接 |
附註與備註
本站收錄交易價格引用的附註、修正申報（Form 4/A）的全部附註，以及申報的備註。其他附註，例如間接持有的方式、交易計畫的細節，請看 SEC EDGAR 上的原文。
- F4
In connection with the closing of the Issuer's IPO (the "IPO Closing") on September 6, 2022, the $66,682.86 of outstanding principal and accrued but unpaid interest of this secured convertible promissory note (a "Note"), dated December 21, 2018, automatically converted into 15,876 shares of Common Stock at a conversion price of $4.20 per share (on a Common Stock equivalent basis).
表 I 有 1 筆交易的價格引用這則附註。
- F5
In connection with the IPO Closing on September 6, 2022, the $1,120,773.84 of outstanding principal and accrued but unpaid interest of this Note, dated December 21, 2018, automatically converted into 266,850 shares of Common Stock at a conversion price of $4.20 per share (on a Common Stock equivalent basis).
表 I 有 1 筆交易的價格引用這則附註。
- F6
In connection with the IPO Closing on September 6, 2022, the $160,808.22 of outstanding principal and accrued but unpaid interest of this Note, dated February 7, 2019, automatically converted into 38,287 shares of Common Stock at a conversion price of $4.20 per share (on a Common Stock equivalent basis).
表 I 有 1 筆交易的價格引用這則附註。
- F7
In connection with the IPO Closing on September 6, 2022, the $394,048 of outstanding principal and accrued but unpaid interest of this Note, dated April 18, 2019, automatically converted into 93,821 shares of Common Stock at a conversion price of $4.20 per share (on a Common Stock equivalent basis).
表 I 有 1 筆交易的價格引用這則附註。
- F8
In connection with the IPO Closing on September 6, 2022, the $268,626.30 of outstanding principal and accrued but unpaid interest of this Note, dated July 26, 2019, automatically converted into 63,958 shares of Common Stock at a conversion price of $4.20 per share (on a Common Stock equivalent basis).
表 I 有 1 筆交易的價格引用這則附註。
- F9
In connection with the IPO Closing on September 6, 2022, the $246,027.40 of outstanding principal and accrued but unpaid interest of this Note, dated October 22, 2019, automatically converted into 58,577 shares of Common Stock at a conversion price of $4.20 per share (on a Common Stock equivalent basis).
表 I 有 1 筆交易的價格引用這則附註。
- F10
In connection with the IPO Closing on September 6, 2022, the 1,612,163 shares of Series A Preferred Stock owned by the Trust automatically converted at the then-effective 1-for-7 conversion rate into 230,309 fully paid and nonassessable shares of Common Stock. The Series A Preferred Stock had no expiration date.
表 I 有 1 筆交易的價格引用這則附註。
- F11
The reported securities are included within 16,326 Units purchased by the Trust for $6.125 per Unit in the Issuer's IPO. Each Unit consists of one share of Common Stock, one tradeable warrant to purchase one share of Common Stock at an exercise price of $7.35 per share, and one five-year non-tradeable warrant to purchase one share of Common Stock at an exercise price of $7.656 per share.
表 I 有 1 筆、表 II 有 2 筆交易的價格引用這則附註。
- F12
Represents a right to purchase 12,241 shares of Common Stock underlying a warrant that became initially exercisable in connection with the IPO Closing on September 6, 2022 at an exercise price equal to the IPO price of $6.125 per share. The warrant was issued to Mr. Rubin on August 25, 2021 as consideration for his agreement to enter into an amendment to that certain Secured Convertible Note Purchase Agreement, dated December 21, 2018, as amended (the "Note Purchase Agreement") to extend the maturity date of the Note issued to him under the Note Purchase Agreement from December 31, 2021 to May 31, 2022.
表 II 有 1 筆交易的價格引用這則附註。
- F13
Represents a right to purchase an aggregate of 408,125 shares of Common Stock underlying five warrants that became initially exercisable in connection with the IPO Closing on September 6, 2022 at an exercise price equal to the IPO price of $6.125 per share. The warrants were issued to the Trust on August 25, 2021 as consideration for the Trust's agreement to enter into an amendment to the Note Purchase Agreement to extend the maturity date of the Notes issued to the Trust under the Note Purchase Agreement from December 31, 2021 to May 31, 2022.
表 II 有 1 筆交易的價格引用這則附註。
- F14
Represents a right to purchase 4,896 shares of Common Stock underlying a warrant at an exercise price of $5.25 per share. The warrant was issued to Mr. Rubin on July 20, 2022 as consideration for his agreement to enter into an amendment to the Note Purchase Agreement to extend the maturity date of the Note issued to him under the Note Purchase Agreement from August 31, 2022 to October 31, 2022.
表 II 有 1 筆交易的價格引用這則附註。
- F15
Represents a right to purchase an aggregate of 163,248 shares of Common Stock underlying five warrants at an exercise price of $5.25 per share. The warrants were issued to the Trust on July 20, 2022 as consideration for the Trust's agreement to enter into an amendment to the Note Purchase Agreement to extend the maturity date of the Notes issued to the Trust under the Note Purchase Agreement from August 31, 2022 to October 31, 2022.
表 II 有 1 筆交易的價格引用這則附註。
備註
Exhibit List - Exhibit 24.1: Power of Attorney (Gary D. Rubin) Exhibit 24.2: Power of Attorney (Harvey Sandler Revocable Trust)