SEC Form 4
FORM 4 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). |
1. Name and Address of Reporting Person*
(Street)
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2. Issuer Name and Ticker or Trading Symbol
Ainos, Inc. [ AIMD ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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3. Date of Earliest Transaction
(Month/Day/Year) 10/26/2022 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed
(Month/Day/Year) |
6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | ||||||||||
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1. Title of Security (Instr. 3) | 2. Transaction Date (Month/Day/Year) | 2A. Deemed Execution Date, if any (Month/Day/Year) | 3. Transaction 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 | ||||||
Common Stock(2) | 10/26/2022 | A | 333,333 | A | $1.89 | 355,599 | D | |||
Common Stock | 22,266(1) | D |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||||||||||
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1. Title of Derivative Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) | 6. Date Exercisable and Expiration Date (Month/Day/Year) | 7. 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: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) | ||||
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
RSU(3) | $1.89 | 10/26/2022 | C | 5,000,000(3) | 09/30/2022 | 10/26/2022 | COMMON | 333,333 | $1.89 | 0 | D | ||||
RSU(4) | (4) | 10/24/2022 | A | 50,000 | (4) | (4) | COMMON | 50,000 | (4) | 50,000 | D |
Explanation of Responses: |
1. The amount of common stock previously reported totaling 333,986 shares is hereby adjusted to 22,266 shares giving effect to a 15-to-1 Reverse Stock Split made effective on August 8, 2022 (the "Reverse Stock Split"). |
2. This reported transaction represents the conversion of 5,000,000 Restricted Stock Units (the "RSUs") adjusted to 333,000 shares giving effect to the Reverse Stock Split. The RSUs were originally granted pursuant to an employment Mandate Agreement dated March 17, 2022 (the "Mandate Agreement") under the Company's 2021 Stock Incentive Plan. The converted shares underlying the RSUs vested on September 30, 2022 and may not be sold within 6 months of the grant date. |
3. This reported transaction represents the settlement of 5,000,000 RSUs adjusted to 333,333 common stock after giving effect the Reverse Stock Split. |
4. This reported transaction represents the granting of 50,000 Restricted Stock Units (the "RSUs"). The RSUs were originally authorized pursuant to an employment Mandate Agreement dated March 17, 2022 (the "Mandate Agreement") and under the Company's 2021 Stock Incentive Plan. The RSUs will vest in increments of 15% on 4/24/23 and 10/24/23, 30% on 10/24/24 and 40% on 10/24/25, subject to normal and customary termination events. |
/s/ John Junyong Lee POA for Chun-Hsien Tsai | 10/26/2022 | |
** Signature of Reporting Person | Date | |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | ||
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v). | ||
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). | ||
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |