Ann Lee - Dec 28, 2022 Form 3 Insider Report for Coya Therapeutics, Inc. (COYA)

Role
Director
Signature
/s/ David Snyder, Attorney-in-Fact
Stock symbol
COYA
Transactions as of
Dec 28, 2022
Transactions value $
$0
Form type
3
Date filed
12/28/2022, 07:43 PM
Previous filing
Jan 4, 2023
Next filing
Mar 5, 2024

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 COYA Stock Option (right to buy) Dec 28, 2022 Common Stock par value $0.0001 per share 17.6K $1.09 Direct F1, F2
holding COYA 6% Convertible Note Dec 28, 2022 Common Stock par value $0.0001 per share 6.45K $4.00 Direct F2, F3
* An asterisk sign (*) next to the price indicates that the price is likely invalid.

Explanation of Responses:

Id Content
F1 The shares underlying the option vest in 36 equal monthly installments commencing on July 1, 2021.
F2 The shares reported reflect the 1 for 5.6955 stock split effected December 12, 2022.
F3 Upon the closing of the Issuer's initial public offering, the Convertible Note will automatically convert into shares of common stock by dividing the then-outstanding principal and interest due under the Convertible Note by $4.00. The Reporting Person holds a Convertible Note for $25,000 that accrues interest at 6% per annum.

Remarks:

Exhibit 24--Power of Attorney