0001140361-21-042258.txt : 20211217 0001140361-21-042258.hdr.sgml : 20211217 20211217171216 ACCESSION NUMBER: 0001140361-21-042258 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211215 FILED AS OF DATE: 20211217 DATE AS OF CHANGE: 20211217 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Dyett John CENTRAL INDEX KEY: 0001610631 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40492 FILM NUMBER: 211502541 MAIL ADDRESS: STREET 1: 11111 SANTA MONICA BLVD., SUITE 2250 CITY: LOS ANGELES STATE: CA ZIP: 90025 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 2021-12-15 0001339005 FEMASYS INC FEMY 0001610631 Dyett John C/O FEMASYS INC. 3950 JOHNS CREEK COURT, SUITE 100 SUWANEE GA 30024 true Common Stock 2021-12-15 4 J 0 3219795 0 D 0 I By Salem Femasys Investors LLC Common Stock 2021-12-15 4 J 0 175635 0 A 290344 I By the Dyett Family Trust As previously disclosed in the Issuer's Registration Statement on Form S-1, the shares of Common Stock held by Salem Femasys Investors LLC, of which the reporting person is a member and manager, were distributed to its members pro rata for no consideration upon the expiration of the lock-up agreement entered into in connection with the Company's initial public offering. Pro rata distribution from Salem Femasys Investors LLC, of which the reporting person is a member and manager, to The Dyett Family Trust, of which the reporting person is the Trustee. /s/ Kathy Lee-Sepsick, Attorney-in-fact 2021-12-17