Initial Statement of Beneficial Ownership (3)
June 01 2022 - 5:00PM
Edgar (US Regulatory)
FORM 3
|
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
|
OMB APPROVAL
OMB Number:
3235-0104
Estimated average burden hours per response...
0.5
|
|
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
|
|
1. Name and Address of Reporting Person
*
Angel Matthew |
2. Date of Event Requiring Statement (MM/DD/YYYY)
5/26/2022
|
3. Issuer Name and Ticker or Trading Symbol
Brooklyn ImmunoTherapeutics, Inc. [BTX]
|
(Last)
(First)
(Middle)
C/O BROOKLYN IMMUNOTHERAPEUTICS, INC., 10355 SCIENCE CENTER DRIVE, SUITE 150 |
4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
_____ Director _____ 10% Owner ___X___ Officer (give title below) _____ Other (specify below) Interim President and CEO / |
(Street)
SAN DIEGO, CA 92121
(City)
(State)
(Zip)
| 5. If Amendment, Date Original Filed(MM/DD/YYYY)
| 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 Beneficially Owned
|
1.Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
Common Stock | 909003 (1) | D | |
Common Stock | 2580663 | I | See Footnote (2) |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
|
1. Title of Derivate Security (Instr. 4) | 2. Date Exercisable and Expiration Date (MM/DD/YYYY) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 5) | 6. Nature of Indirect Beneficial Ownership (Instr. 5) |
Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Explanation of Responses: |
(1) | Includes 285,888 shares of common stock of Brooklyn ImmunoTherapeutics, Inc. (the "Issuer") held in escrow until July 16, 2022 to secure indemnification obligations to the Issuer in connection with the Issuer's acquisition of Novellus, Inc. from Novellus, LLC in July 2021, which was co-founded by Dr. Angel. |
(2) | Common stock is owned by Factor Bioscience, Inc., of which Dr. Angel owns approximately 64% of the outstanding equity. |
Remarks: See Exhibit 24.1 - Power of Attorney |
Reporting Owners
|
Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Angel Matthew C/O BROOKLYN IMMUNOTHERAPEUTICS, INC. 10355 SCIENCE CENTER DRIVE, SUITE 150 SAN DIEGO, CA 92121 |
|
| Interim President and CEO |
|
Signatures
|
/s/ Matthew Angel | | 6/1/2022 |
**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 5(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). |
Note: | File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. |
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. |
Brooklyn ImmunoTherapeut... (AMEX:BTX)
Historical Stock Chart
From Mar 2024 to Apr 2024
Brooklyn ImmunoTherapeut... (AMEX:BTX)
Historical Stock Chart
From Apr 2023 to Apr 2024