Gloria Felcyn - May 7, 2021 Form 4 Insider Report for Mosaic ImmunoEngineering Inc. (CPMV)

Role
Director
Signature
/s/ Paul Lytle, as attorney-in-fact for Gloria Felcyn
Stock symbol
CPMV
Transactions as of
May 7, 2021
Transactions value $
$25,000
Form type
4
Date filed
5/10/2021, 04:05 PM
Next filing
Feb 22, 2022

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 CPMV Convertible Note Other $25K $25K May 7, 2021 See Footnotes Self as trustee of GLORIA H. FELCYN 1998 SEPARATE PROPERTY TRUST F1, F2, F3
* An asterisk sign (*) next to the price indicates that the price is likely invalid.

Explanation of Responses:

Id Content
F1 The Convertible Notes were issued on May 7, 2021 in exchange of $25,000 in proceeds to the Company; have no stated maturity date or expiration date; bear interest at a simple rate equal to eight percent (8.0%) per annum until converted; and automatically convert into the same equity securities offered in the Qualified Financing (see footnote 2 and 3) or at the option of the holder into the same equity securities offered in a Smaller Financing (see footnote 2 and 3).
F2 Upon a Qualified Financing or Smaller Financing (see footnote 3), the conversion price shall be equal to the lower of (i) the product equal to 80% times the lowest per unit purchase price of the equity securities issued for cash in the Qualified Financing or Smaller Financing (representing a 20% discount), or (ii) $2.377, representing $21 million divided by the number of fully diluted shares of Common Stock outstanding, including common stock reversed for issuance under the Company's Series B Convertible Voting Preferred Stock and the Company's 2020 Equity Incentive Plan as of the issuance date.
F3 A Qualified Financing represents a single transaction or series or transactions whereby the Company receives aggregate gross proceeds of at least $5 million from the sale of equity securities following the issuance date of the Convertible Note (excluding proceeds from the issuance of any future Convertible Notes). A Smaller Financing represents any sale of equity securities whereby the aggregate gross proceeds are less than $5 million (excluding proceeds from the issuance of any future Convertible Notes).