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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OMB APPROVAL |
OMB Number: |
3235-0287 |
Estimated average burden |
hours per response: |
0.5 |
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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). |
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Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan for the purchase or sale of equity securities of the issuer that is intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10. |
1. Name and Address of Reporting Person*
8880 RIO SAN DIEGO DRIVE |
SUITE 800 |
(Street)
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2. Issuer Name and Ticker or Trading Symbol
Ainos, Inc.
[ AIMD ]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X |
Director |
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10% Owner |
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Officer (give title below) |
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Other (specify below) |
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3. Date of Earliest Transaction
(Month/Day/Year) 01/31/2024
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4. If Amendment, Date of Original Filed
(Month/Day/Year)
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6. Individual or Joint/Group Filing (Check Applicable Line)
X |
Form filed by One Reporting Person |
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Form filed by More than One Reporting Person |
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned |
1. Title of Security (Instr.
3)
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2. Transaction Date
(Month/Day/Year) |
2A. Deemed Execution Date, if any
(Month/Day/Year) |
3. Transaction Code (Instr.
8)
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4. Securities Acquired (A) or Disposed Of (D) (Instr.
3, 4 and 5)
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5.
Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr.
3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr.
4)
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7. Nature of Indirect Beneficial Ownership (Instr.
4)
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Code |
V |
Amount |
(A) or (D) |
Price |
Common Stock
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01/31/2024 |
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A |
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1,466 |
A |
$0.94
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52,932 |
D |
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Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivative Security (Instr.
3)
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2. Conversion or Exercise Price of Derivative Security
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3. Transaction Date
(Month/Day/Year) |
3A. Deemed Execution Date, if any
(Month/Day/Year) |
4. Transaction Code (Instr.
8)
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5.
Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr.
3, 4 and 5)
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6. Date Exercisable and Expiration Date
(Month/Day/Year) |
7. Title and Amount of Securities Underlying Derivative Security (Instr.
3 and 4)
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8. Price of Derivative Security (Instr.
5)
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9.
Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr.
4)
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10. Ownership Form: Direct (D) or Indirect (I) (Instr.
4)
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11. Nature of Indirect Beneficial Ownership (Instr.
4)
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Code |
V |
(A) |
(D) |
Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
RSU
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01/31/2024 |
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C |
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1,466 |
01/31/2024 |
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Common Stock |
1,466 |
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1,466 |
D |
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Explanation of Responses: |
Remarks: |
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/s/ Chun-Hsien Tsai POA for Pao-Sheng Wei |
02/02/2024 |
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** 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). |
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 Number. |
LIMITED POWER OF ATTORNEY
The
undersigned hereby constitutes and appoints Chun-Hsien Tsai, and
with full power of substitution, the undersigned’s true and
lawful attorney-in-fact to:
(1)
execute for and on behalf of the undersigned, in the
undersigned’s capacity as officer, director and/or
shareholder of Ainos, Inc. (the “Company”), from time
to time the following U.S. Securities and Exchange Commission
(“SEC”) forms: (i) Form ID, including any
attached documents, to effect the assignment of codes to the
undersigned to be used in the transmission of information to the
SEC using the EDGAR System; (ii) Form 3, Initial
Statement of Beneficial Ownership of Securities, including any
attached documents; (iii) Form 4, Statement of
Changes in Beneficial Ownership of Securities, including any
attached documents; (iv) Form 5, Annual Statement of
Beneficial Ownership of Securities in accordance with
Section 16(a) of the Securities Exchange Act of 1934, as
amended, and the rules thereunder, including any attached
documents; (v) Schedule 13D and (vi) amendments of each
thereof, in accordance with the Securities Exchange Act of 1934, as
amended, and the rules thereunder, including any attached
documents;
(2)
do and perform any and all acts for and on behalf of the
undersigned which may be necessary or desirable to complete and
execute any such Form 3, 4 or 5, Schedule 13D or any
amendment(s) thereto, and timely file such form(s) with
the SEC and any securities exchange, national association or
similar authority; and
(3)
take any other action of any type whatsoever in connection with the
foregoing which, in the opinion of such attorney-in-fact, may be of
benefit to, in the best interest of, or legally required by, the
undersigned, it being understood that the documents executed by
such attorney-in-fact on behalf of the undersigned pursuant to this
Power of Attorney shall be in such form and shall contain such
terms and conditions as such attorney-in-fact may approve in such
attorney-in-fact’s discretion.
The
undersigned hereby grants to each such attorney-in-fact, acting
singly, full power and authority to do and perform any and every
act and thing whatsoever requisite, necessary or proper to be done
in the exercise of any of the rights and powers herein granted, as
fully to all intents and purposes as the undersigned might or could
do if personally present, with full power of substitution or
revocation, hereby ratifying and confirming all that such
attorney-in-fact, or such attorney-in-fact’s substitute or
substitutes, shall lawfully do or cause to be done by virtue of
this power of attorney and the rights and powers herein
granted. The undersigned acknowledges that the foregoing
attorneys-in-fact, in serving in such capacity at the request of
the undersigned, are not assuming, nor is the Company assuming, any
of the undersigned’s responsibilities to comply with
Section 16 or Regulation 13D-G of the Securities Exchange Act
of 1934, as amended. The undersigned hereby agrees to
indemnify the attorneys-in-fact and the Company from and against
any demand, damage, loss, cost or expense arising from any false or
misleading information provided by the undersigned to the
attorneys-in-fact.
This
Power of Attorney shall remain in full force and effect until the
undersigned is no longer required to file such forms with respect
to the undersigned’s holdings of and transactions in
securities issued by the Company, unless earlier revoked by the
undersigned in a signed writing delivered to the foregoing
attorneys-in-fact. This Power of Attorney supersedes any
prior power of attorney in connection with the undersigned’s
capacity as an officer and/or director of the Company. This
Power of Attorney shall expire as to any individual
attorney-in-fact if such attorney-in-fact ceases to be an executive
officer of, or legal counsel to, the Company.
IN WITNESS WHEREOF, the undersigned has caused this Power of
Attorney to be executed as of January 16, 2024.
/s/
Pao-Sheng Wei
Name:
Pao-Sheng Wei
LIMITED POWER OF ATTORNEY
The
undersigned hereby constitutes and appoints Chun-Hsien Tsai, and
with full power of substitution, the undersigned’s true and
lawful attorney-in-fact to:
(1)
execute for and on behalf of the undersigned, in the
undersigned’s capacity as officer, director and/or
shareholder of Ainos, Inc. (the “Company”), from time
to time the following U.S. Securities and Exchange Commission
(“SEC”) forms: (i) Form ID, including any
attached documents, to effect the assignment of codes to the
undersigned to be used in the transmission of information to the
SEC using the EDGAR System; (ii) Form 3, Initial
Statement of Beneficial Ownership of Securities, including any
attached documents; (iii) Form 4, Statement of
Changes in Beneficial Ownership of Securities, including any
attached documents; (iv) Form 5, Annual Statement of
Beneficial Ownership of Securities in accordance with
Section 16(a) of the Securities Exchange Act of 1934, as
amended, and the rules thereunder, including any attached
documents; (v) Schedule 13D and (vi) amendments of each
thereof, in accordance with the Securities Exchange Act of 1934, as
amended, and the rules thereunder, including any attached
documents;
(2)
do and perform any and all acts for and on behalf of the
undersigned which may be necessary or desirable to complete and
execute any such Form 3, 4 or 5, Schedule 13D or any
amendment(s) thereto, and timely file such form(s) with
the SEC and any securities exchange, national association or
similar authority; and
(3)
take any other action of any type whatsoever in connection with the
foregoing which, in the opinion of such attorney-in-fact, may be of
benefit to, in the best interest of, or legally required by, the
undersigned, it being understood that the documents executed by
such attorney-in-fact on behalf of the undersigned pursuant to this
Power of Attorney shall be in such form and shall contain such
terms and conditions as such attorney-in-fact may approve in such
attorney-in-fact’s discretion.
The
undersigned hereby grants to each such attorney-in-fact, acting
singly, full power and authority to do and perform any and every
act and thing whatsoever requisite, necessary or proper to be done
in the exercise of any of the rights and powers herein granted, as
fully to all intents and purposes as the undersigned might or could
do if personally present, with full power of substitution or
revocation, hereby ratifying and confirming all that such
attorney-in-fact, or such attorney-in-fact’s substitute or
substitutes, shall lawfully do or cause to be done by virtue of
this power of attorney and the rights and powers herein
granted. The undersigned acknowledges that the foregoing
attorneys-in-fact, in serving in such capacity at the request of
the undersigned, are not assuming, nor is the Company assuming, any
of the undersigned’s responsibilities to comply with
Section 16 or Regulation 13D-G of the Securities Exchange Act
of 1934, as amended. The undersigned hereby agrees to
indemnify the attorneys-in-fact and the Company from and against
any demand, damage, loss, cost or expense arising from any false or
misleading information provided by the undersigned to the
attorneys-in-fact.
This
Power of Attorney shall remain in full force and effect until the
undersigned is no longer required to file such forms with respect
to the undersigned’s holdings of and transactions in
securities issued by the Company, unless earlier revoked by the
undersigned in a signed writing delivered to the foregoing
attorneys-in-fact. This Power of Attorney supersedes any
prior power of attorney in connection with the undersigned’s
capacity as an officer and/or director of the Company. This
Power of Attorney shall expire as to any individual
attorney-in-fact if such attorney-in-fact ceases to be an executive
officer of, or legal counsel to, the Company.
IN WITNESS WHEREOF, the undersigned has caused this Power of
Attorney to be executed as of January 16, 2024.
/s/
Pao-Sheng Wei
Name:
Pao-Sheng Wei
Ainos (NASDAQ:AIMD)
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