Jason Hsu - Dec 20, 2021 Form 4 Insider Report for Immix Biopharma, Inc. (IMMX)

Role
Director
Signature
/s/ Ilya Rachman as Attorney-In-Fact for Jason Hsu
Stock symbol
IMMX
Transactions as of
Dec 20, 2021
Transactions value $
$578,526
Form type
4
Date filed
12/20/2021, 03:15 PM
Previous filing
Dec 15, 2021
Next filing
Jul 18, 2022

Transactions Table

Type Sym Class Transaction Value $ Shares Change % * Price $ Shares After Date Ownership Footnotes
transaction IMMX Common Stock Conversion of derivative security $3.33M +3.92M $0.85 3.92M Dec 20, 2021 See Footnote F1
transaction IMMX Common Stock Purchase $250K +50K $5.00 50K Dec 20, 2021 See Footnote 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 IMMX Convertible Note Conversion of derivative security -$3M 0 Dec 20, 2021 Common stock 3.92M $0.85 See Footnote F1, F3
* An asterisk sign (*) next to the price indicates that the price is likely invalid.

Explanation of Responses:

Id Content
F1 Jason Hsu is the Sole Member of VERITAS LIBERABIT VOS, LLC ("VL") and in such capacity has the right to vote and dispose of the securities held by such entity.
F2 Jason Hsu is the Sole Member of Signature Collection Properties, LLC and in such capacity has the right to vote and dispose of the securities held by such entity.
F3 On September 1, 2016, the Registrant issued VL a note in the amount of $3 million which is payable upon request of the majority holders of like tenure notes on or after March 31, 2022. Pursuant to the terms of the note, because the Registrant sold equity securities in its initial public offering resulting in proceeds of at least $10 million, the note automatically converted into shares of the Registrant's common stock.