Paul Buckman - Jun 28, 2021 Form 4 Insider Report for Miromatrix Medical Inc. (MIRO)

Role
Director
Signature
/s/ Elise B. Houser, Attorney-in-Fact
Stock symbol
MIRO
Transactions as of
Jun 28, 2021
Transactions value $
$0
Form type
4
Date filed
6/29/2021, 06:01 PM
Previous filing
Jun 23, 2021
Next filing
Sep 14, 2021

Transactions Table

Type Sym Class Transaction Value $ Shares Change % * Price $ Shares After Date Ownership Footnotes
transaction MIRO Common Stock Conversion of derivative security +3K +54.01% 8.56K Jun 28, 2021 By Paul R. Buckman Revocable Trust F1

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
transaction MIRO Series B-2 Preferred Stock Conversion of derivative security -3K -100% 0 Jun 28, 2021 Common Stock 3K By Paul R. Buckman Revocable Trust F1
* An asterisk sign (*) next to the price indicates that the price is likely invalid.

Explanation of Responses:

Id Content
F1 Each share of Series B-2 Preferred Stock had no expiration date and automatically converted into one share of Common Stock upon the closing of the Issuer's initial public offering.