SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
Zannes Maria

(Last) (First) (Middle)
19702 BELLA LOMA, #6005

(Street)
SAN ANTONIO TX 78256

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
bioAffinity Technologies, Inc. [ BIAF ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
X Officer (give title below) Other (specify below)
President, CEO
3. Date of Earliest Transaction (Month/Day/Year)
08/31/2022
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock(1) 08/31/2022 P 16,326 A (2) 19,897 D
Common Stock(1) 09/06/2022 C 23,672(3) A $4.2(3) 43,569 D
Common Stock(1) 11/17/2022 A(5) 18,099(5) A $0 61,668 D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Warrants (right to buy)(1) $7.35(2) 08/31/2022 P 16,326 08/31/2022 08/31/2027 Common Stock 16,326 (2) 16,326 D
Non-tradeable Warrants (right to buy)(1) $7.656(2) 08/31/2022 P 16,326 08/31/2022 08/31/2027 Common Stock 16,326 (2) 16,326 D
Unsecured Convertible Promissory Note(1) $4.2(3) 09/06/2022 C $99,423.12 09/06/2022(3) 10/31/2022 Common Stock 23,672 $0 0 D
Warrants (right to buy)(1) $6.125(4) 09/06/2022 A 23,571 09/06/2022(4) 08/11/2027 Common Stock 23,571 (4) 23,571 D
Explanation of Responses:
1. The number of securities and exercise prices reported in this Form 4 reflect the 1-for-7 reverse stock split of the common stock, par value $0.007 (the "Common Stock"), of bioAffinity Technologies, Inc. (the "Issuer"), which became effective with the State of Delaware on June 23, 2022 in connection with the Issuer's initial public offering (the "IPO").
2. The reported securities are included within 16,326 Units purchased by Ms. Zannes for $6.125 per Unit in the Issuer's IPO. Each Unit consists of one share of Common Stock, one five-year tradeable warrant to purchase one share of Common Stock at an exercise price of $7.35 per share, and one five-year non-tradeable warrant to purchase one share of Common Stock at an exercise price of $7.656 per share.
3. In connection with the IPO closing on September 6, 2022, the $99,423.12 of outstanding principal and accrued but unpaid interest of Ms. Zannes's unsecured convertible promissory note, dated August 11, 2022, automatically converted into 23,672 shares of Common Stock at a conversion price of $4.20 per share (on a Common Stock equivalent basis).
4. Represents a right to purchase 23,571 shares of Common Stock underlying a warrant that became initially exercisable in connection with the IPO closing on September 6, 2022 at an exercise price equal to the IPO price of $6.125 per share. The warrant was issued to Ms. Zannes on August 11, 2022 as consideration for funds Ms. Zannes paid to the Issuer for her unsecured convertible promissory note, dated August 11, 2022.
5. Represents a grant from the Issuer to Ms. Zannes of 18,099 restricted shares of Common Stock on November 17, 2022 under the Issuer's 2014 Equity Incentive Plan. The restricted stock will begin vesting on December 17, 2022 in 12 monthly installments, the first 11 of which will be of 1,508 shares of Common Stock and the last of which will be of the remaining 1,511 shares of Common Stock, subject to Ms. Zannes's continuous service to the Issuer through each vesting date.
Remarks:
Exhibit List - Exhibit 24.1: Power of Attorney (Maria Zannes)
/s/ Wilhelm E. Liebmann, as attorney-in-fact for Maria Zannes 11/22/2022
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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