0001493152-24-024828.txt : 20240621 0001493152-24-024828.hdr.sgml : 20240621 20240621174513 ACCESSION NUMBER: 0001493152-24-024828 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20240611 FILED AS OF DATE: 20240621 DATE AS OF CHANGE: 20240621 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Rachman Ilya M CENTRAL INDEX KEY: 0001889334 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-41159 FILM NUMBER: 241061535 MAIL ADDRESS: STREET 1: 11400 WEST OLYMPIC BLVD., STREET 2: SUITE 200 CITY: LOS ANGELES STATE: CA ZIP: 90064 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Immix Biopharma, Inc. CENTRAL INDEX KEY: 0001873835 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] ORGANIZATION NAME: 03 Life Sciences IRS NUMBER: 454869378 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 11400 WEST OLYMPIC BLVD. STREET 2: SUITE 200 CITY: LOS ANGELES STATE: CA ZIP: 90064 BUSINESS PHONE: (888) 958-1084 MAIL ADDRESS: STREET 1: 10573 W. PICO BLVD. STREET 2: #58 CITY: LOS ANGELES STATE: CA ZIP: 90064 4 1 ownership.xml X0508 4 2024-06-11 0 0001873835 Immix Biopharma, Inc. IMMX 0001889334 Rachman Ilya M C/O IMMIX BIOPHARMA, INC. 11400 WEST OLYMPIC BLVD., SUITE 200 LOS ANGELES CA 90064 1 1 0 0 CEO and Chairman 0 Common Stock 1136259 D Stock Option (Right to Buy) 2.04 2024-06-11 4 A 0 340000 0.00 A 2034-06-11 Common Stock 340000 340000 D The Stock Option will vest in 48 equal monthly installments following the date of grant, subject to the Reporting Person's continued service with the Issuer. /s/ Ilya Rachman 2024-06-21