0001683168-22-001214.txt : 20220222
0001683168-22-001214.hdr.sgml : 20220222
20220222200111
ACCESSION NUMBER: 0001683168-22-001214
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20220218
FILED AS OF DATE: 20220222
DATE AS OF CHANGE: 20220222
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: KING STEVEN W
CENTRAL INDEX KEY: 0001244106
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-22182
FILM NUMBER: 22660289
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Mosaic ImmunoEngineering Inc.
CENTRAL INDEX KEY: 0000836564
STANDARD INDUSTRIAL CLASSIFICATION: BIOLOGICAL PRODUCTS (NO DIAGNOSTIC SUBSTANCES) [2836]
IRS NUMBER: 841070278
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 19881 BROOKHURST STREET, C-245
CITY: HUNTINGTON BEACH
STATE: CA
ZIP: 92646
BUSINESS PHONE: 657-208-0890
MAIL ADDRESS:
STREET 1: 19881 BROOKHURST STREET, C-245
CITY: HUNTINGTON BEACH
STATE: CA
ZIP: 92646
FORMER COMPANY:
FORMER CONFORMED NAME: PATRIOT SCIENTIFIC CORP
DATE OF NAME CHANGE: 19920703
FORMER COMPANY:
FORMER CONFORMED NAME: PATRIOT FINANCIAL CORP
DATE OF NAME CHANGE: 19920521
4
1
ownership.xml
X0306
4
2022-02-18
0
0000836564
Mosaic ImmunoEngineering Inc.
CPMV
0001244106
KING STEVEN W
1537 SOUTH NOVATO BLVD., #5
NOVATO
CA
94947
1
1
1
0
President and CEO
Convertible Note
2022-02-18
4
J
0
20000
20000
A
See footnotes
20000
D
The Convertible Notes were issued on February 18, 2022 in exchange of $20,000 in proceeds to the Company; have no stated maturity date or expiration date; bear interest at a simple rate equal to eight percent (8.0%) per annum until converted; and automatically convert into the same equity securities offered in the Qualified Financing (see footnote 2 and 3) or at the option of the holder into the same equity securities offered in a Smaller Financing (see footnote 2 and 3).
Upon a Qualified Financing or Smaller Financing (see footnote 3), the conversion price shall be equal to the lower of (i) the product equal to 80% times the lowest per unit purchase price of the equity securities issued for cash in the Qualified Financing or Smaller Financing (representing a 20% discount), or (ii) $1.00.
A Qualified Financing represents a single transaction or series or transactions whereby the Company receives aggregate gross proceeds of at least $5 million from the sale of equity securities following the issuance date of the Convertible Note (excluding proceeds from the issuance of any future Convertible Notes). A Smaller Financing represents any sale of equity securities whereby the aggregate gross proceeds are less than $5 million (excluding proceeds from the issuance of any future Convertible Notes).
/s/ Paul Lytle, as attorney-in-fact for Steven King
2022-02-22