George Cappy - Aug 2, 2023 Form 4 Insider Report for MIRA PHARMACEUTICALS, INC. (MIRA)

Role: 10%+ Owner
Signature: /s/ Michelle Yanez, Attorney-in-Fact for George Cappy
Stock symbol: MIRA
Transactions as of: Aug 2, 2023
Transactions value $: $1,100,190
Form type: 4
Date filed: 8/4/2023, 01:42 PM
Next filing: Aug 24, 2023

Transactions Table

Type	Sym	Class	Transaction	Value $	Shares	Change %	* Price $	Shares After	Date	Ownership	Footnotes
transaction	MIRA	Common Stock	Purchase	$1.1M	+157K	+6.08%	$7.00	2.74M	Aug 2, 2023	By Trust	F1, F2
holding	MIRA	Common Stock						20K	Aug 2, 2023	Direct	F3

Derivative Securities (e.g., puts, calls, warrants, options, convertible securities)

Type	Sym	Class	Transaction	Value $	Shares	Change %	* Price $	Shares After	Date	Underlying Class	Amount	Exercise Price	Ownership	Footnotes
holding	MIRA	Common Stock Warrant (right to buy)						1M	Aug 2, 2023	Common Stock	1M	$5.00	By Trust	F2

* An asterisk sign (*) next to the price indicates that the price is likely invalid.

Explanation of Responses:

Id	Content
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.