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