Cappy George 4
4 · MIRA PHARMACEUTICALS, INC. · Filed Aug 4, 2023
Insider Transaction Report
Form 4
Cappy George
10% Owner
Transactions
- Purchase
Common Stock
2023-08-02$7.00/sh+157,170$1,100,190→ 2,740,270 total(indirect: By Trust)
Holdings
- 20,000
Common Stock
- 1,000,000(indirect: By Trust)
Common Stock Warrant (right to buy)
Exercise: $5.00From: 2023-04-28Exp: 2028-04-28→ Common Stock (1,000,000 underlying)
Footnotes (3)
- [F1]Represents the acquisition of shares of common stock by the Bay Shore Trust (the "Trust") through the conversion of an aggregate of $1,100,190 of indebtedness owing by the Issuer to the Trust, with such conversion occurring on the date of the Issuer's initial public offering at a conversion price of $7.00 per share.
- [F2]These securities are owned directly by the Trust, a greater-than-10% owner of the Issuer. As sole trustee of the Trust, George Cappy ("Mr. Cappy") has sole ownership and dispositive power over these securities and is therefore deemed to be an indirect beneficial owner of the securities for purposes of SEC Rule 13d-3, although Mr. Cappy disclaims beneficial ownership of the reported securities due to the absence of any pecuniary interest therein.
- [F3]These securities are owned directly by Mr. Cappy.