Jeffrey James Ross - 28 Jun 2021 Form 4/A - Amendment Insider Report for Miromatrix Medical Inc.

Role: CHIEF EXECUTIVE OFFICER, Director
Signature: /s/ Steven J. Conley, Attorney-in-Fact
Issuer symbol: N/A
Transactions as of: 28 Jun 2021
Net transactions value: $0
Form type: 4/A - Amendment
Filing time: 18 Jan 2022, 18:10:45 UTC
Date Of Original Report: 29 Jun 2021
Previous filing: 23 Jun 2021
Next filing: 05 Jan 2022
SEC: View on sec.gov

Transactions Table

Type	Sym	Class	Transaction	Value $	Shares	Change %	* Price $	Shares After	Date	Ownership	Footnotes
transaction	MIRO	Common Stock	Conversion of derivative security	$0	+4,400	+2.2%	$0.000000	208,150	28 Jun 2021	Direct	F1, F2

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 Preferred Stock	Conversion of derivative security		-4,400	-100%		0	28 Jun 2021	Common Stock	4,400		Direct	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 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.
F2	The reporting person's Form 4 filed on June 29, 2021 inadvertently understated the reporting person's direct holdings by 203,750 shares.