0001104659-21-145061.txt : 20211130
0001104659-21-145061.hdr.sgml : 20211130
20211130181408
ACCESSION NUMBER: 0001104659-21-145061
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20211126
FILED AS OF DATE: 20211130
DATE AS OF CHANGE: 20211130
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: GREEN DAVID
CENTRAL INDEX KEY: 0001008643
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35853
FILM NUMBER: 211460679
MAIL ADDRESS:
STREET 1: C/O HARVARD BIOSCIENCE INC
STREET 2: 84 OCTOBER HILL ROAD
CITY: HOLLISTON
STATE: MA
ZIP: 01746-1371
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Biostage, Inc.
CENTRAL INDEX KEY: 0001563665
STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841]
IRS NUMBER: 455210462
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 84 OCTOBER HILL ROAD
STREET 2: SUITE 11
CITY: HOLLISTON
STATE: MA
ZIP: 01746
BUSINESS PHONE: (774) 233-7300
MAIL ADDRESS:
STREET 1: 84 OCTOBER HILL ROAD
STREET 2: SUITE 11
CITY: HOLLISTON
STATE: MA
ZIP: 01746
FORMER COMPANY:
FORMER CONFORMED NAME: Harvard Apparatus Regenerative Technology, Inc.
DATE OF NAME CHANGE: 20121204
4
1
tm2134262d2_4seq1.xml
OWNERSHIP DOCUMENT
X0306
4
2021-11-26
0
0001563665
Biostage, Inc.
BSTG
0001008643
GREEN DAVID
C/O BIOSTAGE, INC.,
84 OCTOBER HILL ROAD, SUITE 11
HOLLISTON
MA
01746
1
1
0
0
Interim CEO
Common Stock
2021-11-26
4
P
0
72464
3.45
A
95516
D
Common Stock
16468
I
2018 Biostage GRAT
Warrant (right to buy)
3.45
2021-11-26
4
P
0
36232
A
2021-11-26
2026-11-26
Common Stock, par value $0.01 per share
36232
36232
D
Stock Option (right to buy)
2.40
2021-11-26
4
A
0
374094
0
A
2031-11-26
Common Stock, par value $0.01 per share
374094
374094
D
On November 26, 2021, the Issuer and the Reporting Person entered into a securities purchase agreement (the "Purchase Agreement") pursuant to which the Reporting Person acquired from the Issuer in a private placement: (i) 72,464 shares of the Issuer's common stock, $0.01 par value (collectively, the "Shares"); and (ii) a warrant to purchase up to 36,232 shares of common stock with an exercise price of $2.00 per share (the "Warrant"). The aggregate subscription amount paid by the Reporting Person for the Shares and Warrant acquired by it pursuant to the Purchase Agreement was $250,000.
Subject to continued employment or service through the applicable vesting dates, (i) 106,884 shares will vest monthly in twelve equal monthly installments on each monthly anniversary of November 26, 2021, and (ii) up to 267,210 shall vest in three increments, two for 80,163 shares each and the third for 106,884 shares, each such vesting subject to certain performance milestones set by the Board of Directors of the Issuer.
This form has been signed under power of attorney.
/s/ Chad Porter, by power of attorney
2021-11-30