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