0001209191-15-086235.txt : 20151218
0001209191-15-086235.hdr.sgml : 20151218
20151218213934
ACCESSION NUMBER: 0001209191-15-086235
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20140919
FILED AS OF DATE: 20151218
DATE AS OF CHANGE: 20151218
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Bone Biologics Corp
CENTRAL INDEX KEY: 0001419554
STANDARD INDUSTRIAL CLASSIFICATION: ORTHOPEDIC, PROSTHETIC & SURGICAL APPLIANCES & SUPPLIES [3842]
IRS NUMBER: 421743430
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 321 COLUMBUS AVE,
CITY: BOSTON
STATE: MA
ZIP: 02116
BUSINESS PHONE: 732-661-2224
MAIL ADDRESS:
STREET 1: 321 COLUMBUS AVE,
CITY: BOSTON
STATE: MA
ZIP: 02116
FORMER COMPANY:
FORMER CONFORMED NAME: Bone Biologics, Corp.
DATE OF NAME CHANGE: 20140924
FORMER COMPANY:
FORMER CONFORMED NAME: AFH ACQUISITION X, INC.
DATE OF NAME CHANGE: 20071127
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: SOO B CHIA
CENTRAL INDEX KEY: 0001655452
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-53078
FILM NUMBER: 151298051
MAIL ADDRESS:
STREET 1: 115 NORTH DOHENY DRIVE
CITY: BEVERLY HILLS
STATE: CA
ZIP: 90211
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2014-09-19
0
0001419554
Bone Biologics Corp
NONE
0001655452
SOO B CHIA
C/O BONE BIOLOGICS CORPORATION
321 COLUMBUS AVENUE
BOSTON
MA
02116
1
0
0
0
Common Stock
2014-09-19
4
J
0
1000000
A
1000000
D
Common Stock
2000000
I
By Spouse
Common Stock
2015-09-19
4
A
0
31646
0.00
A
1031646
D
Common Stock
2015-10-09
4
S
0
52744
1.58
D
978902
D
Common Stock
2015-10-22
5
G
0
E
2000000
0.00
D
0
I
By Spouse
Common Stock
2015-10-22
5
G
0
E
2000000
0.00
A
2978902
D
Warrant (Right to Buy)
0.44
2014-09-19
4
J
0
119318
A
2024-09-19
Common Stock
119318
119318
D
Common Stock (Right to Acquire)
0.00
2015-10-02
4
A
0
384615.33
0.00
A
Common Stock
384615.33
384615.33
D
Represents shares of Common Stock of the Issuer issued pursuant to that certain Agreement and Plan of Merger (the "Merger Agreement"), dated as of September 19, 2014 by and among AFH Acquisition X, Inc., Bone Biologics, Inc. and Bone Biologics Acquisition Corp. Pursuant to the terms of the Merger Agreement each share of Common Stock of Bone Biologics, Inc. was converted into the same number of shares of the Issuer's Common Stock.
These shares are owned by Kang Ting. Dr. Ting is the spouse of the Reporting Person. The Reporting Person disclaims beneficial ownership of these securities, and this report shall not be deemed an admission that the Reporting Person is the beneficial owner of such securities for purposes of Section 16 or for any other purpose.
Does not include 384,615.33 shares of Common Stock issuable to Dr. Ting on the earlier of September 24, 2018 and the occurrence of certain events described in a letter agreement by and between the Issuer and the Reporting Person dated September 24, 2015 and attached as Exhibit 10.1 to Form 8-K filed with the Securities and Exchange Commission on October 8, 2015.
These shares were acquired by the Reporting Person pursuant to Reporting Person's non-employee director offer letter with the Issuer.
These shares were sold by the Reporting Person in a private transaction.
This transaction involved a gift of the shares of Common Stock owned by Dr. Ting to the Reporting Person.
On February 4, 2010, the Reporting Person acquired a warrant to purchase 119,318 shares of Common Stock of Bone Biologics, Inc.at an exercise price of $0.44 per share. Pursuant to the Merger Agreement, this warrant was converted into a warrant to purchase 119,318 shares of the Issuer's Common Stock at a per share exercise price of $0.44. The warrant is fully vested and exercisable.
Immediately exercisable.
Issuable to the Reporting Person on the earlier of September 24, 2018 and the occurrence of certain events described in a letter agreement by and between the Issuer and the Reporting Person dated September 24, 2015 and attached as Exhibit 10.1 to Form 8-K filed with the Securities and Exchange Commission on October 8, 2015.
/s/Chia Soo
2015-12-18