Home/Filings/4/0000897069-23-001091
4//SEC Filing

Cappy George 4

Accession 0000897069-23-001091

CIK 0001904286other

Filed

Aug 3, 8:00 PM ET

Accepted

Aug 4, 1:42 PM ET

Size

9.0 KB

Accession

0000897069-23-001091

Insider Transaction Report

Form 4
Period: 2023-08-02
Transactions
  • Purchase

    Common Stock

    2023-08-02$7.00/sh+157,170$1,100,1902,740,270 total(indirect: By Trust)
Holdings
  • Common Stock

    20,000
  • Common Stock Warrant (right to buy)

    (indirect: By Trust)
    Exercise: $5.00From: 2023-04-28Exp: 2028-04-28Common Stock (1,000,000 underlying)
    1,000,000
Cappy George
10% Owner
Transactions
  • Purchase

    Common Stock

    2023-08-02$7.00/sh+157,170$1,100,1902,740,270 total(indirect: By Trust)
Holdings
  • Common Stock

    20,000
  • Common Stock Warrant (right to buy)

    (indirect: By Trust)
    Exercise: $5.00From: 2023-04-28Exp: 2028-04-28Common Stock (1,000,000 underlying)
    1,000,000
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.

Documents

1 file

Issuer

MIRA PHARMACEUTICALS, INC.

CIK 0001904286

Entity typeother

Related Parties

1
  • filerCIK 0001986372

Filing Metadata

Form type
4
Filed
Aug 3, 8:00 PM ET
Accepted
Aug 4, 1:42 PM ET
Size
9.0 KB