Filing Details

Accession Number:
0001493152-21-032034
Form Type:
4
Zero Holdings:
No
Publication Time:
2021-12-20 16:15:13
Reporting Period:
2021-12-20
Accepted Time:
2021-12-20 16:15:13
SEC Url:
Form 4 Filing
Issuer
Cik Name Symbol Sector (SIC) IRS No
1873835 Immix Biopharma Inc. IMMX Pharmaceutical Preparations (2834) 454869378
Insiders
Cik Name Reported Address Insider Title Director Officer Large Shareholder Other
1889522 Carey Ng C/O Immix Biopharma, Inc.
11400 West Olympic Blvd., Suite 200
Los Angeles CA 90064
Yes No No No
Reported Non-Derivative Transactions
Sec. Name Acquisiton - Disposition Date Amount Price Remaning Holdings Equity Swap Involved Form Type Code Nature of Ownership Explanation
Common Stock Acquisiton 2021-12-20 1,000,221 $0.85 1,000,221 No 4 C Indirect See footnote
Common Stock Acquisiton 2021-12-20 25,000 $5.00 1,025,221 No 4 P Indirect See footnote
Equity Swap Involved Form Type Code Nature of Ownership Explanation
No 4 C Indirect See footnote
No 4 P Indirect See footnote
Reported Derivative Transactions
Sec. Name Sec. Type Acquisiton - Disposition Date Amount Price Amount - 2 Price - 2
Common Stock Convertible Note Disposition 2021-12-20 0 $0.00 1,000,221 $0.85
Remaning Holdings Exercise Date Expiration Date Equity Swap Involved Transaction Form Type Transaction Code Nature of Ownership
0 No 4 C Indirect
Footnotes
  1. Carey Ng is the Managing Director of Mesa Verde Venture Partners III, LP and in such capacity has the right to vote and dispose of the securities held by such entity.
  2. On October 30, 2019, the Registrant issued Mesa Verde Venture Partners III, LP a note in the amount of $750,000 which is payable upon request of the majority holders of like tenure notes on or after October 30, 2021. Pursuant to the terms of the note, because the Registrant sold equity securities in its initial public offering resulting in proceeds of at least $10 million, the note automatically converted into shares of the Registrant's common stock.