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