0001104659-23-061928.txt : 20230517 0001104659-23-061928.hdr.sgml : 20230517 20230517170205 ACCESSION NUMBER: 0001104659-23-061928 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230517 FILED AS OF DATE: 20230517 DATE AS OF CHANGE: 20230517 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Unis Douglas CENTRAL INDEX KEY: 0001976656 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-41707 FILM NUMBER: 23932634 MAIL ADDRESS: STREET 1: 3913 TODD LANE CITY: AUSTIN STATE: TX ZIP: 78744 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: MONOGRAM ORTHOPAEDICS INC CENTRAL INDEX KEY: 0001769759 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 812349540 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 53 BRIDGE STREET UNIT 507 CITY: BROOKLYN STATE: NY ZIP: 11201 BUSINESS PHONE: (718) 576-3205 MAIL ADDRESS: STREET 1: 3913 TODD LANE STREET 2: SUITE 307 CITY: AUSTIN STATE: TX ZIP: 78744 3 1 tm2315908-2_3seq1.xml OWNERSHIP DOCUMENT X0206 3 2023-05-17 0 0001769759 MONOGRAM ORTHOPAEDICS INC MGRM 0001976656 Unis Douglas 3913 TODD LANE AUSTIN TX 78744 1 0 0 0 Common Stock 3516998 D Options to acquire Common Stock 0.3061 2023-05-17 Common Stock 360000 D Options to acquire Common Stock 2.00 2023-05-17 Common Stock 750000 D Options to acquire Common Stock 1.67 2023-05-17 Common Stock 330000 D N/A /s/Noel Knape on behalf of Douglas Unis 2023-05-17