0001213900-24-065718.txt : 20240806 0001213900-24-065718.hdr.sgml : 20240806 20240806164718 ACCESSION NUMBER: 0001213900-24-065718 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20240802 FILED AS OF DATE: 20240806 DATE AS OF CHANGE: 20240806 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Ciccio John CENTRAL INDEX KEY: 0001974196 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-42195 FILM NUMBER: 241180111 MAIL ADDRESS: STREET 1: C/O OS THERAPIES INCORPORATED STREET 2: 15825 SHADY GROVE ROAD, SUITE 135 CITY: ROCKVILLE STATE: MD ZIP: 20850 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: OS Therapies Inc CENTRAL INDEX KEY: 0001795091 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] ORGANIZATION NAME: 03 Life Sciences IRS NUMBER: 825118368 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 15825 SHADY GROVE ROAD STREET 2: SUITE 135 CITY: ROCKVILLE STATE: MD ZIP: 20850 BUSINESS PHONE: 410-297-7793 MAIL ADDRESS: STREET 1: 15825 SHADY GROVE ROAD STREET 2: SUITE 135 CITY: ROCKVILLE STATE: MD ZIP: 20850 FORMER COMPANY: FORMER CONFORMED NAME: OS THERAPIES Inc DATE OF NAME CHANGE: 20191125 4 1 ownership.xml X0508 4 2024-08-02 0 0001795091 OS Therapies Inc OSTX 0001974196 Ciccio John C/O OS THERAPIES INCORPORATED 15825 SHADY GROVE ROAD, SUITE 135 ROCKVILLE MD 20850 1 0 0 0 0 Common stock, par value $0.001 per share ("Common Stock") 2024-08-02 4 C 0 101765 A 139265 I Mill River Partners LLC Common Stock 2024-08-02 4 C 0 266306 A 405571 I Mill River Partners LLC Common Stock 2024-08-02 4 C 0 30264 A 435835 I Mill River Partners LLC Common Stock 20000 D These shares of Common Stock were issued upon the automatic conversion, which occurred upon the consummation of the Issuer's initial public offering, of a convertible promissory note held by Mill River Partners LLC ("MRP") in the principal amount of $25,000 at a conversion price of $0.39 per share. These shares of Common Stock were issued upon the automatic conversion, which occurred upon the consummation of the Issuer's initial public offering, of a convertible promissory note held by MRP in the principal amount of $75,000 at a conversion price of $0.39 per share. These shares of Common Stock were issued upon the automatic conversion, which occurred upon the consummation of the Issuer's initial public offering, of a convertible promissory note held by MRP in the principal amount of $50,000 at a conversion price of $2.00 per share. John Ciccio serves on the board of managers of MRP and shares voting and investment power with respect to these shares. /s/ John Ciccio 2024-08-06