0001104659-24-088546.txt : 20240812 0001104659-24-088546.hdr.sgml : 20240812 20240812214917 ACCESSION NUMBER: 0001104659-24-088546 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20240812 FILED AS OF DATE: 20240812 DATE AS OF CHANGE: 20240812 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Zabrowski Dan CENTRAL INDEX KEY: 0001940818 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-42139 FILM NUMBER: 241198558 MAIL ADDRESS: STREET 1: C/O APEXIGEN INC STREET 2: 75 SHOREWAY ROAD, SUITE C CITY: SAN CARLOS STATE: CA ZIP: 94070 FORMER NAME: FORMER CONFORMED NAME: Zabrowksi Dan DATE OF NAME CHANGE: 20220802 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: ACTUATE THERAPEUTICS, INC. CENTRAL INDEX KEY: 0001652935 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] ORGANIZATION NAME: 03 Life Sciences IRS NUMBER: 473044785 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1751 RIVER RUN STREET 2: SUITE 400 CITY: FORT WORTH STATE: TX ZIP: 76107 BUSINESS PHONE: 847-986-4190 MAIL ADDRESS: STREET 1: 1751 RIVER RUN STREET 2: SUITE 400 CITY: FORT WORTH STATE: TX ZIP: 76107 FORMER COMPANY: FORMER CONFORMED NAME: Apotheca Therapeutics, Inc. DATE OF NAME CHANGE: 20150911 3 1 tm2420079-5_3seq1.xml OWNERSHIP DOCUMENT X0206 3 2024-08-12 0 0001652935 ACTUATE THERAPEUTICS, INC. ACTU 0001940818 Zabrowski Dan C/O ACTUATE THERAPEUTICS, INC. 1751 RIVER RUN, SUITE 400 FORT WORTH TX 76107 1 0 0 0 Common Stock 76348 I By Catharine A. Zabrowski Irrevocable Trust Non-Qualified Stock Options 2.14 2033-08-30 Common Stock 15942 I By Catharine A. Zabrowski Irrevocable Trust Represents shares held by the Catharine A. Zabrowski Irrevocable Trust, of which Catherine A. Zabrowski, the wife of the reporting person, is the trustee and has sole voting and investment power over such shares and options. The reporting person may be deemed to have or share such investment and/or voting power due to the trustee's status as his spouse. The reporting person disclaims beneficial ownership of such shares other than to the extent he may have a pecuniary interest therein. 15,942 stock options, which are held by the Catharine A. Zabrowski Irrevocable Trust, that are exercisable for shares of common stock of the issuer were fully vested as of April 30, 2024. Exhibit List Exhibit 24 - Power of Attorney /s/ Paul Lytle, Attorney-in-Fact 2024-08-12 EX-24 2 tm2420079d5_ex24.htm EXHIBIT 24

Exhibit 24

POWER OF ATTORNEY

Know all by these present, that the undersigned does hereby constitute and appoint Paul Lytle, Janis Penman, Janet Spreen, Brittany Stevenson and Michael Gunther, and each of them, as the undersigned’s true and lawful attorneys-in-fact and agents to do any and all things, and execute any or all instruments which, after the advice of counsel, said attorneys and agents may deem necessary and advisable to enable the undersigned to comply with the Securities Exchange Act of 1934, as amended, and any rules, regulations and requirements of the Securities and Exchange Commission (“SEC”), including specifically, but without limitation thereof, power of attorney to sign the undersigned’s name to a Form ID, Form 144, Form 3, Form 4, Form 5, Schedule 13D or Schedule 13G and any amendments thereto, to be filed with the SEC; and the undersigned does hereby ratify and confirm all that any of said attorneys and agents shall do or cause to be done by virtue hereof. The undersigned may revoke the authority granted herein upon delivering a signed written notice to the foregoing attorneys-in-fact.

Executed on this 13th day of June, 2024.

/s/ Dan Zabrowski
Name: Dan Zabrowski