0001493152-23-023815.txt : 20230706 0001493152-23-023815.hdr.sgml : 20230706 20230706161516 ACCESSION NUMBER: 0001493152-23-023815 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230101 FILED AS OF DATE: 20230706 DATE AS OF CHANGE: 20230706 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Harvey Sandler Revocable Trust CENTRAL INDEX KEY: 0001323253 STATE OF INCORPORATION: FL FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-41463 FILM NUMBER: 231073753 BUSINESS ADDRESS: STREET 1: 21170 N. E. 22ND COURT CITY: NORTH MIAMI BEACH STATE: FL ZIP: 33180 BUSINESS PHONE: 954-389-7100 MAIL ADDRESS: STREET 1: 21170 N. E. 22ND COURT CITY: NORTH MIAMI BEACH STATE: FL ZIP: 33180 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Rubin Gary D CENTRAL INDEX KEY: 0001947569 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-41463 FILM NUMBER: 231073754 MAIL ADDRESS: STREET 1: 2080 NW BOCA RATON BLVD STREET 2: STE 2 CITY: BOCA RATON STATE: FL ZIP: 33431 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: bioAffinity Technologies, Inc. CENTRAL INDEX KEY: 0001712762 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMMERCIAL PHYSICAL & BIOLOGICAL RESEARCH [8731] IRS NUMBER: 465211056 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 22211 WEST INTERSTATE-10 STREET 2: SUITE 1206 CITY: SAN ANTONIO STATE: TX ZIP: 78257 BUSINESS PHONE: 210-698-5334 MAIL ADDRESS: STREET 1: 22211 WEST INTERSTATE-10 STREET 2: SUITE 1206 CITY: SAN ANTONIO STATE: TX ZIP: 78257 4 1 ownership.xml X0407 4 2023-01-01 0 0001712762 bioAffinity Technologies, Inc. BIAF 0001947569 Rubin Gary D C/O BIOAFFINITY TECHNOLOGIES, INC. 22211 WEST INTERSTATE 10, SUITE 1206 SAN ANTONIO, TX 78257 1 0 1 0 0001323253 Harvey Sandler Revocable Trust C/O GARY RUBIN, CO-TRUSTEE 2080 NW BOCA RATON BLVD, SUITE 2 BOCA RATON, FL 33431 0 0 1 0 0 Common Stock 2023-01-01 4 A 0 8227 2.28 A 59817 D Common Stock 2023-04-15 4 A 0 9920 1.89 A 69737 D Common Stock 2023-07-01 4 A 0 10245 1.83 A 79982 D Common Stock 1584144 I By Trust Represents a grant from bioAffinity Technologies, Inc. (the "Issuer") to Mr. Rubin of 8,227 restricted shares of common stock, par value $0.007 (the "Common Stock"), on January 1, 2023 under the Issuer's 2014 Equity Incentive Plan, which shares of restricted stock will vest ratably over three months of continued service beginning on the date of grant and which represents a restricted stock award valued at $18,750 granted by the Issuer to each of its directors each quarter during the calendar year. Represents a grant from the Issuer to Mr. Rubin of 9,920 restricted shares of Common Stock on April 15, 2023 under the Issuer's 2014 Equity Incentive Plan, which shares of restricted stock will vest one-third on the date of grant, one-third on May 1, 2023 and the remaining shares on June 1, 2023, provided Mr. Rubin continues to serve as a director, and which represents a restricted stock award valued at $18,750 granted by the Issuer to each of its directors each quarter during the calendar year. Represents a grant from the Issuer to Mr. Rubin of 10,245 restricted shares of Common Stock, on July 1, 2023 under the Issuer's 2014 Equity Incentive Plan, which shares of restricted stock will vest ratably over three months of continued service beginning on the date of grant and which represents a restricted stock award valued at $18,750 granted by the Issuer to each of its directors each quarter during the calendar year. Represents shares of Common Stock owned directly by the Harvey Sandler Revocable Trust (the "Trust"), a 10% owner of the Issuer, and indirectly by Mr. Rubin, as co-trustee of the Trust, which indirect ownership was previously reported on a Form 4 filed by Mr. Rubin and the Trust on October 21, 2022. Mr. Rubin disclaims beneficial ownership of the reported securities except to the extent of his pecuniary interest therein. /s/ Gary D. Rubin 2023-07-05