Keyvan Samini - 05 May 2025 Form 4 Insider Report for MOBIX LABS, INC (MOBX)

Source evidence Original filing metadata and source links for verification. 5 source fields
SEC form
4
Accepted by SEC
07 May 2025, 21:16:57 UTC
Prior SEC filing
17 Apr 2025
Next SEC filing
13 Aug 2025
Source filing
View source filing
Reporting owner 1 detail
Reporting owner signature
/s/ Terri Aprati, Attorney-in-Fact

Key filing fact

Keyvan Samini filed Form 4 for MOBIX LABS, INC (MOBX) on 07 May 2025.

Key facts

  • This page summarizes Keyvan Samini's Form 4 filing for MOBIX LABS, INC (MOBX).
  • 1 reported transaction and 3 derivative rows are listed below.
  • Accepted by SEC: 07 May 2025, 21:16.

Change

  • Previous filing in this sequence was filed on 17 Apr 2025.
  • Current net transaction value: $0.

Research use

  • This tells you what this filing adds before you inspect full transaction and derivative tables.
  • You can trace every row back to the original SEC filing document.

Evidence

Filed on Form 4

Ownership activity is grounded in SEC Form 4 disclosures.

View source filing

Reporting Owners (1)

CIK 0002004846 Primary reporting owner

SAMINI KEYVAN

Relationship
President, CFO & Director, Director
Address
C/O MOBIX LABS, INC., 15420 LAGUNA CANYON RD., SUITE 100, IRVINE
Signature
/s/ Terri Aprati, Attorney-in-Fact
Signature date
07 May 2025

Reported non-derivative transactions

Shares, units, or other non-derivative securities reported in this filing.

MOBX transaction

Class A Common Stock

Award

Transaction value
$0
Shares
+2,550,000
Change %
Price
$0.000000
Shares after
2,550,000
Date
05 May 2025
Ownership
Direct
Footnotes
F1, F2
MOBX holding

Class A Common Stock

No transaction description listed

Transaction value
Shares
Change %
Price
Shares after
73,529
Date
05 May 2025
Ownership
By KSLI Trust
Footnotes
F3
MOBX holding

Class A Common Stock

No transaction description listed

Transaction value
Shares
Change %
Price
Shares after
171,146
Date
05 May 2025
Ownership
By KSSF Trust
Footnotes
F3
MOBX holding

Class A Common Stock

No transaction description listed

Transaction value
Shares
Change %
Price
Shares after
73,529
Date
05 May 2025
Ownership
By SSLI Trust
Footnotes
F3

Reported derivative securities

Options, warrants, convertible securities, or similar derivative positions disclosed in the filing.

MOBX holding Derivative

Option (Right to Buy)

No transaction description listed

Transaction value
Shares
Change %
Price
Shares after
323,529
Date
05 May 2025
Ownership
Direct
Underlying class
Class A Common Stock
Underlying amount
323,529
Exercise price
$0.1700
Footnotes
F4, F5
MOBX holding Derivative

Restricted Stock Units

No transaction description listed

Transaction value
Shares
Change %
Price
Shares after
333,333
Date
05 May 2025
Ownership
Direct
Underlying class
Class A Common Stock
Underlying amount
333,333
Exercise price
Footnotes
F6, F7
MOBX holding Derivative

Class B Common Stock

No transaction description listed

Transaction value
Shares
Change %
Price
Shares after
125,000
Date
05 May 2025
Ownership
Direct
Underlying class
Class A Common Stock
Underlying amount
125,000
Exercise price
Footnotes
F8
* marks a reported price that did not pass the local price check.

Additional SEC filing notes

Filing notes and footnotes

Explanation of responses 8 footnotes

Footnote F1

These Restricted Stock Awards ("RSAs") were granted to the Reporting Person on May 5, 2025 and will vest over a two year period and can be accelerated if certain stock price thresholds are met.

Footnote F2

This amount reflects the correct number of shares directly held by the Reporting Person and corrects an error filed in the previous Form 4 filed on April 17, 2025, in which 323,529 shares were inadvertently reported on Table I and should have only been reflected as options in Table II.

Footnote F3

The Reporting Person is a trustee of this trust. The Reporting Person disclaims beneficial ownership of the securities held by this trust except to the extent of his respective pecuniary interest therein.

Footnote F4

These options are fully vested and exercisable.

Footnote F5

This amount reflects the correct number of options held by the Reporting Person and corrects an administrative error filed in the previous Form 4 filed on April 17, 2025.

Footnote F6

The Restricted Stock Units ("RSUs") convert to Class A Common Stock on a one-for-one basis.

Footnote F7

These RSUs will vest on December 21, 2025.

Footnote F8

The shares of Class B Common Stock are convertible into shares of Class A Common Stock at the option of the Reporting Person, and will be automatically converted upon (i) a transfer by the Reporting Person (other than a permitted transfer) or (ii) the first trading day after the seventh anniversary date of the Closing Date (December 21, 2023).

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