Amended Statement of Changes in Beneficial Ownership (4/a)
27 Maio 2022 - 5:43PM
Edgar (US Regulatory)
FORM 4
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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).
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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3235-0287
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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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1. Name and Address of Reporting Person
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Venkatesan Jay |
2. Issuer Name and Ticker or Trading Symbol
Angion Biomedica Corp.
[
ANGN
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director _____ 10% Owner __X__ Officer (give title below) _____ Other (specify below) See Remarks |
(Last)
(First)
(Middle)
C/O ANGION BIOMEDICA CORP., 51 CHARLES LINDBERGH BLVD. |
3. Date of Earliest Transaction
(MM/DD/YYYY)
2/9/2021 |
(Street)
UNIONDALE, NY 11553
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
2/11/2021 |
6. Individual or Joint/Group Filing
(Check Applicable Line)
_X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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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)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code (Instr. 8)
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4. Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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Common Stock | 2/9/2021 | | X | | 396329 | A | $6.43 | 1598440 | D | |
Common Stock | 2/9/2021 | | S(1) | | 159177 | D | $16 | 1367263 | D | |
Common Stock | 2/9/2021 | | C | | 262 | A | $11.57 | 1439525 | D | |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Trans. Date | 3A. Deemed Execution Date, if any | 4. 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 Date | 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 of Derivative Security: 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 |
Warrant to Purchase Common Stock | $6.43 | 2/9/2021 | | X | | | 396329 | (1) | 7/5/2028 | Common Stock | 396329.0 | $0 | 0 | D | |
Explanation of Responses: |
(1) | On February 9, 2021 the Reporting Person exercised a warrant to purchase an aggregate of 396,329 shares of the Issuer's common stock for $6.43 a share. The Reporting Person paid the exercise price on a cashless basis, resulting in the issuer's withholding of 159,177 of the warrant shares to pay the exercise price and issuing to the Reporting Person the remaining 237,152 shares of common stock. |
Remarks: President and Chief Executive Officer and Director |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Venkatesan Jay C/O ANGION BIOMEDICA CORP. 51 CHARLES LINDBERGH BLVD. UNIONDALE, NY 11553 | X |
| See Remarks |
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Signatures
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/s/ Jennifer J. Rhodes, as attorney-in fact for Jay. R. Venkatesan | | 5/27/2022 |
**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 control number. |
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