0001493152-24-024006.txt : 20240614
0001493152-24-024006.hdr.sgml : 20240614
20240614212707
ACCESSION NUMBER: 0001493152-24-024006
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20240612
FILED AS OF DATE: 20240614
DATE AS OF CHANGE: 20240614
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Harvey Sandler Revocable Trust
CENTRAL INDEX KEY: 0001323253
ORGANIZATION NAME:
STATE OF INCORPORATION: FL
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-41463
FILM NUMBER: 241046810
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
ORGANIZATION NAME:
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-41463
FILM NUMBER: 241046811
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]
ORGANIZATION NAME: 08 Industrial Applications and Services
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
X0508
4
2024-06-12
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
2024-06-12
4
A
0
8296
0.00
A
112813
D
Common Stock
1584144
I
By Trust
Grant of restricted shares of common stock, par value $0.007 per share, that vest immediately.
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.. Mr. Rubin disclaims beneficial ownership of the reported securities except to the extent of his pecuniary interest therein.
/s/ Maria Zannes, as attorney-in-fact for Gary D. Rubin
2024-06-14
/s/ Maria Zannes, as attorney-in-fact for Gary D. Rubin, the Co-Trustee of the Harvey Sandler Revocable Trust
2024-06-14