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*
Wu Hui-Lan

(Last) (First) (Middle)
8880 RIO SAN DIEGO DRIVE, SUITE 800

(Street)
SAN DIEGO CA 92108

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
Ainos, Inc. [ AIMD ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Chief Financial Officer
3. Date of Earliest Transaction (Month/Day/Year)
08/09/2022
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(5) 08/09/2022 A 14,705 A $3.4 18,905 I Daughter(1)(2)
Common Stock(4) 11,200 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
RSU (3) 07/28/2022 A 2,000,000 09/30/2022 09/30/2022 Common Stock 2,000,000 $0.01 2,000,000 D
Explanation of Responses:
1. Yun-Huan Liao is Hui-Lan Wu's daughter
2. Reference is made to that certain Convertible Note Purchase Agreement and Convertible Promissory Note ("Note") in the principal amount of $50,000 between the Issuer and the Reporting Person's daughter, Yun-Han Liao. The Note bears no interest, matures on March 30, 2027, and is subject to mandatory conversion at a conversion price of 80% of an initial property offering price (if the Issuer conducts an initial public offering). On 08/11/22, the Company completed a public offering at a $4.25 per unit price ("Offering") and a 15-for-1 reverse stock split on 08/08/22 ("Reverse Split"). Transaction reflects an acquisition price of $3.40 per share (80% of the Offering) and the issued shares give effect to the Reverse Split.
3. Reference is made to the Restricted Stock Units (the "RSU") granted pursuant to an employment Mandate Agreement dated March 17, 2022 (the "Mandate Agreement") under the Company's 2021 Stock Incentive Plan. Each RSU represents a right to receive one (1) share of common stock upon vesting and the expiration of any applicable restricted period, or in the sole discretion of the Compensation Committee, the cash value thereof (or any combination thereof). Holders of RSUs have no rights or privileges as a stockholder. The shares underlying the RSUs will vest on September 30, 2022 and are may not be sold within 6 months of the grant date.
4. Prior to the Reverse Split discussed herein the Reporting Person beneficially owned 168,000 shares of common stock of the Issuer and after the Reverse Split, the Reporting Person owned 11,200 common stock.
5. Prior to the Reverse Split discussed herein the Reporting Person beneficially owned 63,000 shares of common stock of the Issuer and after the Reverse Split, and prior to the present issuances, 4,200 common stock. The amounts of securities beneficially owned in column 5 of this report is calculated from a post-split baseline of 4,200.
/s/ John Junyong Lee POA for Hui-Lan Wu 08/11/2022
** 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).
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.