0001493152-22-017155.txt : 20220617 0001493152-22-017155.hdr.sgml : 20220617 20220617160613 ACCESSION NUMBER: 0001493152-22-017155 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210830 FILED AS OF DATE: 20220617 DATE AS OF CHANGE: 20220617 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Agah Ramtin CENTRAL INDEX KEY: 0001862617 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40738 FILM NUMBER: 221023799 MAIL ADDRESS: STREET 1: 4546 EL CAMINO REAL STREET 2: SUITE 223 CITY: LOS ALTOS STATE: CA ZIP: 94022 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: RenovoRx, Inc. CENTRAL INDEX KEY: 0001574094 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 271448452 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 333 W. SANTA CLARA STREET, SUITE 900 CITY: SAN JOSE STATE: CA ZIP: 95110 BUSINESS PHONE: 408-800-2649 MAIL ADDRESS: STREET 1: 333 W. SANTA CLARA STREET, SUITE 900 CITY: SAN JOSE STATE: CA ZIP: 95110 4 1 ownership.xml X0306 4 2021-08-30 0 0001574094 RenovoRx, Inc. RNXT 0001862617 Agah Ramtin C/O RENOVORX, INC., 4546 EL CAMINO REAL, SUITE B1 LOS ALTOS, CA 94022 1 1 1 0 Chief Medical Officer Common Stock 2021-08-30 4 C 0 1295 A 976295 D Convertible Notes 2021-08-30 4 C 0 1295 0 D Common Stock 1295 0 D Warrants (right to buy) 10.80 2021-08-30 4 C 0 1295 0 A 2026-08-30 Common Stock 1295 1295 D Upon the closing of the Issuer's initial public offering, each Convertible Note, plus accrued interest, automatically converted into (i) one share of common stock and (ii) one five-year warrant to purchase one share of common stock at an exercise price equal to $10.80 per share. The shares of Common Stock underlying the warrant are immediately exercisable. /s/ Ramtin Agah MD 2022-06-17