Statement of Changes in Beneficial Ownership (4)
31 Décembre 2019 - 12:02AM
Edgar (US Regulatory)
FORM 4
[ ]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0287
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0.5
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Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
*
GROSSMAN JONAS |
2. Issuer Name and Ticker or Trading Symbol
BiomX Inc.
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PHGE
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director __X__ 10% Owner _____ Officer (give title below) _____ Other (specify below)
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(Last)
(First)
(Middle)
C/O CHARDAN CAPITAL MARKETS LLC, 17 STATE STREET, 21 FLOOR |
3. Date of Earliest Transaction
(MM/DD/YYYY)
12/20/2019 |
(Street)
NEW YORK, NY 10004
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
_X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security (Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code (Instr. 8)
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4. Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Trans. Date | 3A. Deemed Execution Date, if any | 4. Trans. Code (Instr. 8) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) | 6. Date Exercisable and Expiration Date | 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) | 8. Price of Derivative Security (Instr. 5) | 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) | 10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) |
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Warrants | $11.50 | | | | | | | 11/27/2019 | 10/28/2024 | Common Stock | 25064 | | 50129 | D | |
Warrants | $11.50 | 12/20/2019 | | J (1) | | | 2900000 | 11/27/2019 | 10/28/2024 | Common Stock | 2900000 | $0 | 0 | I | See footnote (1) |
Explanation of Responses: |
(1) | Represents private warrants held by Mountain Wood, LLC of which Jonas Grossman ceased to be managing member on December 20, 2019. Upon Mr. Grossman no longer being managing member of Moutain Wood, LLC, he ceased to beneficially own the shares held by Mountain Wood, LLC. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
GROSSMAN JONAS C/O CHARDAN CAPITAL MARKETS LLC 17 STATE STREET, 21 FLOOR NEW YORK, NY 10004 | X | X |
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Signatures
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/s/ Jonas Grossman | | 12/30/2019 |
**Signature of Reporting Person | Date |
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