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CPMV Mosaic ImmunoEngineering Inc (PK)

0.42
0.10 (31.25%)
31 May 2024 - Closed
Delayed by 15 minutes
Share Name Share Symbol Market Type
Mosaic ImmunoEngineering Inc (PK) USOTC:CPMV OTCMarkets Common Stock
  Price Change % Change Share Price Bid Price Offer Price High Price Low Price Open Price Shares Traded Last Trade
  0.10 31.25% 0.42 0.063 1.00 0.42 0.22 0.32 2,623 20:58:51

Statement of Changes in Beneficial Ownership (4)

10/05/2021 9:06pm

Edgar (US Regulatory)


FORM 4 [ ] Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).         
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
                                                                                  
OMB APPROVAL
OMB Number: 3235-0287
Estimated average burden
hours per response...
0.5                       
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
                      

1. Name and Address of Reporting Person *

GARNICK ROBERT L
2. Issuer Name and Ticker or Trading Symbol

Mosaic ImmunoEngineering Inc. [ CPMV ]
5. Relationship of Reporting Person(s) to Issuer (Check all applicable)

__X__ Director                    _____ 10% Owner
_____ Officer (give title below)    _____ Other (specify below)
(Last)          (First)          (Middle)

1537 SOUTH NOVATO BLVD., #5
3. Date of Earliest Transaction (MM/DD/YYYY)

5/7/2021
(Street)

NOVATO, CA 94947
(City)        (State)        (Zip)
4. If Amendment, Date Original Filed (MM/DD/YYYY)

 
6. Individual or Joint/Group Filing (Check Applicable Line)

_X _ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person

Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1.Title of Security
(Instr. 3)
2. Trans. Date 2A. Deemed Execution Date, if any 3. Trans. Code
(Instr. 8)
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price

Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivate Security
(Instr. 3)
2. Conversion or Exercise Price of Derivative Security3. Trans. Date3A. Deemed Execution Date, if any4. Trans. Code
(Instr. 8)
5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
6. Date Exercisable and Expiration Date7. Title and Amount of Securities Underlying Derivative Security
(Instr. 3 and 4)
8. Price of Derivative Security
(Instr. 5)
9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4)10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4)11. Nature of Indirect Beneficial Ownership (Instr. 4)
CodeV(A)(D)Date ExercisableExpiration DateTitleAmount or Number of Shares
Convertible Note (1) (2)(3)5/7/2021  J   $100000     (1)(2)(3) (1)See Footnotes (1)(2)(3) (2)(3)$100000 $100000 (2)(3)D  

Explanation of Responses:
(1) The Convertible Notes were issued on May 7, 2021 in exchange of $100,000 in proceeds to the Company; have no stated maturity date or expiration date; bear interest at a simple rate equal to eight percent (8.0%) per annum until converted; and automatically convert into the same equity securities offered in the Qualified Financing (see footnote 2 and 3) or at the option of the holder into the same equity securities offered in a Smaller Financing (see footnote 2 and 3).
(2) Upon a Qualified Financing or Smaller Financing (see footnote 3), the conversion price shall be equal to the lower of (i) the product equal to 80% times the lowest per unit purchase price of the equity securities issued for cash in the Qualified Financing or Smaller Financing (representing a 20% discount), or (ii) $2.377, representing $21 million divided by the number of fully diluted shares of Common Stock outstanding, including common stock reversed for issuance under the Company's Series B Convertible Voting Preferred Stock and the Company's 2020 Equity Incentive Plan as of the issuance date.
(3) A Qualified Financing represents a single transaction or series or transactions whereby the Company receives aggregate gross proceeds of at least $5 million from the sale of equity securities following the issuance date of the Convertible Note (excluding proceeds from the issuance of any future Convertible Notes). A Smaller Financing represents any sale of equity securities whereby the aggregate gross proceeds are less than $5 million (excluding proceeds from the issuance of any future Convertible Notes).

Reporting Owners
Reporting Owner Name / Address
Relationships
Director10% OwnerOfficerOther
GARNICK ROBERT L
1537 SOUTH NOVATO BLVD., #5
NOVATO, CA 94947
X



Signatures
/s/ Paul Lytle, as attorney-in-fact for Robert Garnick5/10/2021
**Signature of Reporting PersonDate

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