0001213900-24-015876.txt : 20240221
0001213900-24-015876.hdr.sgml : 20240221
20240221175709
ACCESSION NUMBER: 0001213900-24-015876
CONFORMED SUBMISSION TYPE: 4/A
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20240214
FILED AS OF DATE: 20240221
DATE AS OF CHANGE: 20240221
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: LAPORTE KATHLEEN
CENTRAL INDEX KEY: 0001196201
ORGANIZATION NAME:
FILING VALUES:
FORM TYPE: 4/A
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-40877
FILM NUMBER: 24661422
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: CERO THERAPEUTICS HOLDINGS, INC.
CENTRAL INDEX KEY: 0001870404
STANDARD INDUSTRIAL CLASSIFICATION: BIOLOGICAL PRODUCTS (NO DIAGNOSTIC SUBSTANCES) [2836]
ORGANIZATION NAME: 03 Life Sciences
IRS NUMBER: 871088814
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 201 HASKINS WAY
STREET 2: SUITE 230
CITY: SOUTH SAN FRANCISCO
STATE: CA
ZIP: 94080
BUSINESS PHONE: 650-407-2376
MAIL ADDRESS:
STREET 1: 201 HASKINS WAY
STREET 2: SUITE 230
CITY: SOUTH SAN FRANCISCO
STATE: CA
ZIP: 94080
FORMER COMPANY:
FORMER CONFORMED NAME: PHOENIX BIOTECH ACQUISITION CORP.
DATE OF NAME CHANGE: 20210630
4/A
1
ownership.xml
X0508
4/A
2024-02-14
2024-02-16
0
0001870404
CERO THERAPEUTICS HOLDINGS, INC.
CERO
0001196201
LAPORTE KATHLEEN
CERO THERAPEUTICS HOLDINGS, INC
201 HASKINS WAY, SUITE 230
SOUTH SAN FRANCISCO
CA
94080
1
0
0
0
0
Series A Convertible Preferred Stock
10
2024-02-14
4
A
0
50
1000
A
Common Stock
5000
50
I
By the Kathleen LaPorte Revocable Trust
On February 14, 2024, the reporting person acquired shares of Series A Convertible Preferred Stock (the "Series A Preferred Stock") in a private placement by the Issuer pursuant to the terms of a Securities Purchase Agreement dated as of February 5, 2024, as amended. Each share of Series A Preferred Stock has a stated value of $1,000 and, at the option of the holder, is convertible into a number of shares of Common Stock determined by dividing (x) the value of the shares of Series A Preferred Stock, plus any additional amounts thereon as of such date of determination, by (y) the conversion price, which is currently $10.00, subject to adjustments. The Series A Preferred Stock has no expiration date.
The reporting person is the trustee of the Kathleen LaPorte Revocable Trust (the "Kathleen Trust") and has sole voting and disposition power with respect to the shares owned by the Kathleen Trust.
This amendment to the Form 4 originally filed on February 16, 2024 is being filed solely to correct the ownership form and nature of indirect beneficial ownership reported in columns 10 and 11 of Table II, respectively.
/s/ Charles Carter, Attorney-in-Fact
2024-02-21