0001615774-18-004659.txt : 20180531 0001615774-18-004659.hdr.sgml : 20180531 20180531152907 ACCESSION NUMBER: 0001615774-18-004659 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20180530 FILED AS OF DATE: 20180531 DATE AS OF CHANGE: 20180531 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Chen Shu-Chih CENTRAL INDEX KEY: 0001552127 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35610 FILM NUMBER: 18871291 MAIL ADDRESS: STREET 1: C/O ATOSSA GENETICS, INC STREET 2: 4105 E MADISON STREET, SUITE 320 CITY: SEATTLE STATE: WA ZIP: 98112 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: ATOSSA GENETICS INC CENTRAL INDEX KEY: 0001488039 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 264753208 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 107 SPRING STREET CITY: SEATTLE STATE: WA ZIP: 98104 BUSINESS PHONE: 206.588.0256 MAIL ADDRESS: STREET 1: 107 SPRING STREET CITY: SEATTLE STATE: WA ZIP: 98104 4 1 s110547_form4.xml OWNERSHIP DOCUMENT X0306 4 2018-05-30 0 0001488039 ATOSSA GENETICS INC ATOS 0001552127 Chen Shu-Chih C/O ATOSSA GENETICS INC. 107 SPRING STREET SEATTLE WA 98104 1 0 0 0 Series B Convertible Preferred Stock 3.52 2018-05-30 5 P 0 E 8 1000 A 2018-05-30 Common Stock 2273 8 I See footnote Warrants 4.05 2018-05-30 5 P 0 E 2272 1000 A 2018-05-30 2022-05-30 Common Stock 2272 2272 I See footnote Each share of Series B Convertible Preferred Stock is convertible into the number of shares of Common Stock equal to the stated value of $1,000 divided by $3.52. Shares of Series B Convertible Preferred Stock do not expire. No fractional shares will be issued upon conversion. At its election, the Company will either issue a cash adjustment or round up to the next whole share. The number reflected here assumes rounding up to the next whole share. Shares of Series B Convertible Preferred Stock and Warrants were issued as part of a unit, with each unit consisting of one share of Series B Convertible Preferred Stock and 284 Warrants. Securities are owned by Ensisheim Partners, LLC ("Ensisheim"). Shu-Chih Chen, Ph.D. and Steven C. Quay, M.D., Ph.D., share voting and investment power over the securities held by Ensisheim. Ensisheim is solely owned and controlled by Drs. Chen and Quay, and, as a result, Drs. Chen and Quay are deemed to be beneficial owners of the shares held by this entity. /s/ Shu-Chih Chen, Ph.D. 2018-05-31