0001140361-21-022190.txt : 20210624
0001140361-21-022190.hdr.sgml : 20210624
20210624165129
ACCESSION NUMBER: 0001140361-21-022190
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210622
FILED AS OF DATE: 20210624
DATE AS OF CHANGE: 20210624
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Adams John Q JR
CENTRAL INDEX KEY: 0001856775
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-40492
FILM NUMBER: 211043479
MAIL ADDRESS:
STREET 1: 35 WYCK HILL LANE
CITY: WESTLAKE
STATE: TX
ZIP: 76262
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: FEMASYS INC
CENTRAL INDEX KEY: 0001339005
STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841]
IRS NUMBER: 000000000
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 3950 JOHNS CREEK COURT
STREET 2: SUITE 100
CITY: SUWANEE
STATE: GA
ZIP: 30024
BUSINESS PHONE: 770-500-3910
MAIL ADDRESS:
STREET 1: 3950 JOHNS CREEK COURT
STREET 2: SUITE 100
CITY: SUWANEE
STATE: GA
ZIP: 30024
4
1
form4.xml
FORM 4
X0306
4
2021-06-22
0001339005
FEMASYS INC
FEMY
0001856775
Adams John Q JR
C/O FEMASYS INC.
3950 JOHNS CREEK COURT, SUITE 100
SUWANEE
GA
30024
true
Common Stock
2021-06-22
4
P
0
40000
13
A
40000
D
Common Stock
2021-06-22
4
C
0
91245
A
131245
D
Common Stock
2021-06-22
4
C
0
108693
A
239938
D
Series B Convertible Preferred Stock
2021-06-22
4
C
0
91245
D
Common Stock
91245
0
D
Series C Convertible Preferred Stock
2021-06-22
4
C
0
108693
D
Common Stock
108693
0
D
91,245 shares of Series B Convertible Preferred Stock were automatically converted into Common Stock in connection with the closing of the Issuer's initial public offering. The Series B Convertible Preferred Stock had no expiration date.
108,693 shares of Series C Convertible Preferred Stock were automatically converted into Common Stock in connection with the closing of the Issuer's initial public offering. The Series C Convertible Preferred Stock had no expiration date.
/s/ Kathy Lee-Sepsick, Attorney-in-fact
2021-06-24