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*
(Street)
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2. Issuer Name and Ticker or Trading Symbol
Predictive Oncology Inc.
[ POAI ]
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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) 10/02/2023
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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 |
10/02/2023 |
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A |
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1,875 |
A |
$0
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17,934 |
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 |
Explanation of Responses: |
Remarks: |
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/s/Josh Blacher, Attorney-in-Fact |
10/04/2023 |
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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. |
Exhibit 24.1
Limited Power of Attorney
Know all by these presents, that the undersigned
hereby makes, constitutes and appoints each of Raymond F. Vennare and Josh Blacher, or either of them acting singly, and with full power
of substitution and re-substitution, the undersigned's true and lawful attorney-in-fact (each of such persons and their substitutes being
referred to herein as the "Attorney-in-Fact"), with full power to act for the undersigned and in the undersigned's name, place
and stead, in any and all capacities, to:
1. Prepare,
execute, and submit to the Securities and Exchange Commission ("SEC") a Form ID, including amendments thereto, and any other
documents necessary or appropriate to obtain codes and passwords enabling the undersigned to make electronic filings with the SEC of reports
required or considered by the Attorney-in-Fact to be advisable under Section 13 or Section 16 of the Securities Exchange Act of 1934 (the
"Exchange Act") or any rule or regulation of the SEC;
2. Prepare,
execute and submit to the SEC, Predictive Oncology Inc. (the "Company"), and/or any national securities exchange on which the
Company's securities are listed any and all reports (including any amendments thereto) the undersigned is required to file with the SEC,
or which the Attorney-in-Fact considers it advisable to file with the SEC, under Section 13 or Section 16 of the Exchange Act or any rule
or regulation thereunder, or under Rule 144 under the Securities Act of 1933 ("Rule 144"), with respect to the any security
of the Company, including Forms 3, 4 and 5, Schedules 13D and 13G, and Forms 144; and
3. Obtain,
as the undersigned's representative and on the undersigned's behalf, information regarding transactions in the Company's equity securities
from any third party, including the Company and any brokers, dealers, employee benefit plan administrators and trustees, and the undersigned
hereby authorizes any such third party to release any such information to the Attorney-in-Fact.
The undersigned
acknowledges that:
a) | | This Power of Attorney authorizes, but does not require, the Attorney-in-Fact to act in his
or her discretion on information provided to such Attorney-in-Fact without independent verification of such information; |
b) | | Any documents prepared or executed by the Attorney-in-Fact on behalf of the undersigned pursuant
to this Power of Attorney will be in such form and will contain such information as the Attorney-in-Fact, in his or her discretion, deems
necessary or desirable; |
c) | | Neither the Company nor the Attorney-in-Fact assumes any liability for the undersigned's
responsibility to comply with the requirements of Section 13 or Section 16 of the Exchange Act or Rule 144, any liability of the undersigned
for any failure to comply with such requirements, or any liability of the undersigned for disgorgement of profits under Section 16(b)
of the Exchange Act; and |
d) | | This Power of Attorney does not relieve the undersigned from responsibility for compliance
with the undersigned's obligations under Section 13 or Section 16 of the Exchange Act, including, without limitation, the reporting requirements
under Section 13 or Section 16 of the Exchange Act. |
The undersigned
hereby grants to the Attorney-in-Fact full power and authority to do and perform each and every act and thing requisite, necessary or
advisable to be done in connection with the foregoing, as fully, to all intents and purposes, as the undersigned might or could do in
person, hereby ratifying and confirming all that the Attorney-in-Fact, or his or her substitute or substitutes, shall lawfully do or cause
to be done by authority of this Power of Attorney.
This Power
of Attorney shall remain in full force and effect until the undersigned is no longer required to file Forms 4 or 5 or Schedules 13D or
13G or Forms 144 with respect to the undersigned's holdings of and transactions in securities of the Company, unless earlier revoked by
the undersigned in a signed writing delivered to the Attorney-in-Fact. This Power of Attorney revokes all previous powers of attorney
with respect to the subject matter of this Power of Attorney.
IN WITNESS
WHEREOF, the undersigned has executed this Power of Attorney as of September 28, 2023.
/s/ Gregory St. Clair Sr.
Signature
Gregory St. Clair Sr.
Printed Name
Exhibit 24.1
Limited Power of Attorney
Know all by these presents, that the undersigned
hereby makes, constitutes and appoints each of Raymond F. Vennare and Josh Blacher, or either of them acting singly, and with full power
of substitution and re-substitution, the undersigned's true and lawful attorney-in-fact (each of such persons and their substitutes being
referred to herein as the "Attorney-in-Fact"), with full power to act for the undersigned and in the undersigned's name, place
and stead, in any and all capacities, to:
1. Prepare,
execute, and submit to the Securities and Exchange Commission ("SEC") a Form ID, including amendments thereto, and any other
documents necessary or appropriate to obtain codes and passwords enabling the undersigned to make electronic filings with the SEC of reports
required or considered by the Attorney-in-Fact to be advisable under Section 13 or Section 16 of the Securities Exchange Act of 1934 (the
"Exchange Act") or any rule or regulation of the SEC;
2. Prepare,
execute and submit to the SEC, Predictive Oncology Inc. (the "Company"), and/or any national securities exchange on which the
Company's securities are listed any and all reports (including any amendments thereto) the undersigned is required to file with the SEC,
or which the Attorney-in-Fact considers it advisable to file with the SEC, under Section 13 or Section 16 of the Exchange Act or any rule
or regulation thereunder, or under Rule 144 under the Securities Act of 1933 ("Rule 144"), with respect to the any security
of the Company, including Forms 3, 4 and 5, Schedules 13D and 13G, and Forms 144; and
3. Obtain,
as the undersigned's representative and on the undersigned's behalf, information regarding transactions in the Company's equity securities
from any third party, including the Company and any brokers, dealers, employee benefit plan administrators and trustees, and the undersigned
hereby authorizes any such third party to release any such information to the Attorney-in-Fact.
The undersigned
acknowledges that:
a) | | This Power of Attorney authorizes, but does not require, the Attorney-in-Fact to act in his
or her discretion on information provided to such Attorney-in-Fact without independent verification of such information; |
b) | | Any documents prepared or executed by the Attorney-in-Fact on behalf of the undersigned pursuant
to this Power of Attorney will be in such form and will contain such information as the Attorney-in-Fact, in his or her discretion, deems
necessary or desirable; |
c) | | Neither the Company nor the Attorney-in-Fact assumes any liability for the undersigned's
responsibility to comply with the requirements of Section 13 or Section 16 of the Exchange Act or Rule 144, any liability of the undersigned
for any failure to comply with such requirements, or any liability of the undersigned for disgorgement of profits under Section 16(b)
of the Exchange Act; and |
d) | | This Power of Attorney does not relieve the undersigned from responsibility for compliance
with the undersigned's obligations under Section 13 or Section 16 of the Exchange Act, including, without limitation, the reporting requirements
under Section 13 or Section 16 of the Exchange Act. |
The undersigned
hereby grants to the Attorney-in-Fact full power and authority to do and perform each and every act and thing requisite, necessary or
advisable to be done in connection with the foregoing, as fully, to all intents and purposes, as the undersigned might or could do in
person, hereby ratifying and confirming all that the Attorney-in-Fact, or his or her substitute or substitutes, shall lawfully do or cause
to be done by authority of this Power of Attorney.
This Power
of Attorney shall remain in full force and effect until the undersigned is no longer required to file Forms 4 or 5 or Schedules 13D or
13G or Forms 144 with respect to the undersigned's holdings of and transactions in securities of the Company, unless earlier revoked by
the undersigned in a signed writing delivered to the Attorney-in-Fact. This Power of Attorney revokes all previous powers of attorney
with respect to the subject matter of this Power of Attorney.
IN WITNESS
WHEREOF, the undersigned has executed this Power of Attorney as of September 28, 2023.
/s/ Gregory St. Clair Sr.
Signature
Gregory St. Clair Sr.
Printed Name
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