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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES 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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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. | SEC 1474 (9-02) |
1. Title of Derivative Security (Instr. 3) |
2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction 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 (Month/Day/Year) |
7. Title and Amount of Underlying Securities (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) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
CHAOUKI STEVEN M 444 WEST LAKE STREET, SUITE 1700 CHICAGO, IL 60606 |
X |
/s/ Steven Chaouki | 08/02/2022 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 4(b)(v). |
** | Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
(1) | These shares were purchased in the initial public offering (the "IPO") of MAIA Biotechnology, Inc. (the "Issuer"), which closed on August 1, 2022. |
(2) | In connection with a crossover round with certain investors consisting of sales of common stock, $0.0001 par value per share ("Common Stock") of the Issuer at a price of $9.00 per share, in the event that the price per share of Common Stock sold in the IPO was less than $9.00 per share, the Issuer, on the closing date of the IPO (August 1, 2022), issued to such investors, so long as they continued to hold such shares of Common Stock purchased in the crossover round, that number of additional shares of Common Stock such that the price per share they paid in the crossover round was equal to the per share price in the Issuer's IPO. As the reporting person purchased 10,000 shares at $9.00 per share in the crossover round that the reporting person continued to hold, and the per share price in the IPO was $5.00 per share, accordingly, at the close of the IPO, the Issuer issued to the reporting person an additional 8,000 shares of Common Stock for no additional consideration. |