0001062993-23-015427.txt : 20230728 0001062993-23-015427.hdr.sgml : 20230728 20230728161244 ACCESSION NUMBER: 0001062993-23-015427 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230726 FILED AS OF DATE: 20230728 DATE AS OF CHANGE: 20230728 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Derby Michael CENTRAL INDEX KEY: 0001809613 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-41475 FILM NUMBER: 231123168 MAIL ADDRESS: STREET 1: 303 SOUTH BROADWAY STREET 2: SUITE 125 CITY: TARRYTOWN STATE: NY ZIP: 10591 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: PaxMedica, Inc. CENTRAL INDEX KEY: 0001811623 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 303 SOUTH BROADWAY, SUITE 125 CITY: TARRYTOWN STATE: NY ZIP: 10591 BUSINESS PHONE: 914-987-2876 MAIL ADDRESS: STREET 1: 303 SOUTH BROADWAY, SUITE 125 CITY: TARRYTOWN STATE: NY ZIP: 10591 4 1 form4.xml STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES X0508 4 2023-07-26 0001811623 PaxMedica, Inc. PXMD 0001809613 Derby Michael C/O PAXMEDICA, INC. 303 SOUTH BROADWAY, SUITE 125 TARRYTOWN NY 10591 1 1 0 0 Executive Chairman 0 Common Stock 2023-07-26 4 F 0 6272 0.717 D 461886 D Common Stock 7336745 I TardiMed Sciences, LLC Shares withheld by issuer to satisfy tax withholding obligations of reporting person resulting from vesting of restricted stock units. The reporting person is the Managing Partner of TardiMed and has sole voting and dispositive control over the shares of Common Stock held by the entity. The reporting person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein. /s/ Stephen D. Sheldon, Jr. Attorney-in-Fact 2023-07-28