0001062993-24-005786.txt : 20240306 0001062993-24-005786.hdr.sgml : 20240306 20240306202623 ACCESSION NUMBER: 0001062993-24-005786 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230204 FILED AS OF DATE: 20240306 DATE AS OF CHANGE: 20240306 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: MAKHIJA SHARMILA CENTRAL INDEX KEY: 0001904151 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40839 FILM NUMBER: 24727849 MAIL ADDRESS: STREET 1: 1731 EMBARCADERO ROAD STREET 2: SUITE 200 CITY: PALO ALTO STATE: CA ZIP: 94303 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: QT IMAGING HOLDINGS, INC. CENTRAL INDEX KEY: 0001844505 STANDARD INDUSTRIAL CLASSIFICATION: ELECTROMEDICAL & ELECTROTHERAPEUTIC APPARATUS [3845] ORGANIZATION NAME: 08 Industrial Applications and Services IRS NUMBER: 861728920 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 3 HAMILTON LANDING STREET 2: SUITE 160 CITY: NOVATO STATE: CA ZIP: 94949 BUSINESS PHONE: 415-842-7250 MAIL ADDRESS: STREET 1: 3 HAMILTON LANDING STREET 2: SUITE 160 CITY: NOVATO STATE: CA ZIP: 94949 FORMER COMPANY: FORMER CONFORMED NAME: GigCapital5, Inc. DATE OF NAME CHANGE: 20210204 4 1 form4.xml STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES X0508 4 2023-02-04 1 0001844505 QT IMAGING HOLDINGS, INC. QTI 0001904151 MAKHIJA SHARMILA C/O QT IMAGING HOLDINGS, INC. 3 HAMILTON LANDING SUITE 160 NOVATO CA 94949 1 0 0 0 0 The reporting person's status as an insider terminated as of February 4, 2023 and that the reporting person therefore is no longer subject to Section 16. /s/ Sharmila Makhija MD 2024-03-06