EX-99.3 4 d796580dex993.htm EX-99.3 EX-99.3

Exhibit 99.3

UNAUDITED PRO FORMA COMBINED FINANCIAL INFORMATION

QT Imaging Holdings, Inc. (f/k/a GigCapital5, Inc.) (the “Company”) is providing the following unaudited pro forma condensed combined financial information to aid you in your analysis of the financial aspects of the business combination between GigCapital5, Inc. and QT Imaging, Inc., which was consummated on March 4, 2024. The historical financial information of QT Imaging, Inc. was derived from the audited financial statements for the year ended December 31, 2023.

The historical financial information of GigCapital5, Inc. was derived from the audited financial statements for the year ended December 31, 2023. This information should be read together with QT Imaging, Inc.’s and GigCapital5 Inc.’s financial statements and related notes.

Description of the Transaction

On March 4, 2024, GigCapital5, Inc. and its wholly owned subsidiary, QTI Merger Sub, Inc., entered into a Business Combination Agreement with QT Imaging, Inc. Following the approval at the special meeting of the stockholders of GigCapital5, Inc. held on February 20, 2024, and pursuant to and in accordance with the terms of the Business Combination Agreement, QTI Merger Sub, Inc. merged with and into QT Imaging, Inc. with QT Imaging Holdings Inc. surviving the merger. Upon the consummation of the merger, GigCapital5, Inc. changed its name to QT Imaging Holdings, Inc.

Subject to and in accordance with the terms of the Business Combination Agreement and customary adjustments, at the effective time of the merger, each share of QT Imaging, Inc. capital stock issued and outstanding immediately prior to the effective time of the merger (including shares issued upon the exercise or conversion of QT Imaging Options, QT Imaging Warrants and QT Imaging Convertible Notes but excluding each share of QT Imaging Common Stock held in the treasury of QT Imaging which will be cancelled without any conversion of such shares of QT Imaging Common Stock held in the treasury and dissenting shares) will be automatically cancelled and converted into (A) a number of shares of GigCapital5 Common Stock equal to the Exchange Ratio of the quotient of (i) the Aggregate Closing Merger Consideration divided by (ii) the QT Imaging Fully Diluted Capital Stock and (B) the contingent right to receive a portion of additional shares of GigCapital5 Common Stock based on the performance of the Combined Company if certain requirements are achieved in accordance with the terms of the Business Combination Agreement, if, as and when payable.

Accounting for the Transactions

The business combination is accounted for as a reverse recapitalization in accordance with U.S. GAAP. Under this method of accounting, GigCapital5, Inc. will be treated as the “acquired” company for financial reporting purposes. This determination was primarily based on QT Imaging, Inc.’s operations comprising substantially all of the ongoing operations of the post-combination company, QT Imaging, Inc.’s senior management comprising substantially all of the senior management of the post-combination company and the existence of a majority voting interest in the post-combination company. Accordingly, for accounting purposes, the business combination is treated as the equivalent of QT Imaging, Inc. issuing stock for the net assets of GigCapital5, Inc., accompanied by a recapitalization. The net assets of GigCapital5, Inc. is stated at historical cost, with no goodwill or other intangible assets recorded. Operations prior to the business combination are the historical operations of QT Imaging, Inc.

Basis of Pro Forma Presentation

The historical financial information has been adjusted to give pro forma effect to events that are related and/or directly attributable to the business combination, are factually supportable and, with respect to the pro forma statements of operations, are expected to have a continuing impact on the results of the post-combination company. The unaudited pro forma condensed combined financial information is for illustrative purposes only. The financial results may have been different had the companies always been combined. You should not rely on the unaudited pro forma condensed combined financial information as being indicative of the historical results that would have been achieved had the companies always been combined or the future results that the post-combination company will experience. QT Imaging, Inc. and GigCapital5, Inc. have not had any historical relationship prior to the business combination. Accordingly, no pro forma adjustments were required to eliminate activities between the companies.


PRO FORMA COMBINED BALANCE SHEET AS OF DECEMBER 31, 2023

(unaudited)

 

     QT Imaging,
Inc.
     GigCapital5,
Inc.
     Pro Forma
Adjustments
        Pro Forma
Balance Sheet
 
ASSETS             

Current Assets

            

Cash and cash equivalents

   $ 164,686      $ 2,438      $ 13,952,525     (A5)   $ 6,173,543  
           230,887     (A2)  
           500,000     (B4)  
           (11,511,550   (B5)  
           1,500,000     (B6)  
           9,005,000     (B2)  
           (556,360   (D1)  
           (297,247   (D2)  
           (107,032   (E)  
           (1,275,250   (F)  
           (2,673,667   (I3)  
           (1,800,887   (I4)  
           (960,000   (J4)  

Restricted cash

     20,000               20,000  

Accounts receivable

     1,290               1,290  

Inventory

     4,418,197               4,418,197  

Prepaid expenses and other current assets

     214,979        94,008        987,013     (I4)     1,296,000  
  

 

 

    

 

 

    

 

 

     

 

 

 

Total current assets

     4,819,152        96,446        6,993,432         11,909,030  

Cash and marketable securities held in Trust Account

        23,302,116        (9,356,221   (Al)     —   
           159,586     (A3)  
           (152,956   (A4)  
           (13,952,525   (A5)  

Property and equipment, net

     490,920               490,920  

Intangible assets, net

     90,139               90,139  

Operating lease right-of-use assets, net

     1,267,121               1,267,121  

Other assets

     39,150               39,150  
  

 

 

    

 

 

    

 

 

     

 

 

 

Total assets

   $ 6,706,482      $ 23,398,562      $ (16,308,684     $ 13,796,360  
  

 

 

    

 

 

    

 

 

     

 

 

 


PRO FORMA COMBINED BALANCE SHEET AS OF DECEMBER 31, 2023 (CONTINUED)

(unaudited)

 

     QT Imaging,
Inc.
     GigCapital5,
Inc.
     Pro Forma
Adjustments
        Pro Forma
Balance Sheet
 
LIABILITIES AND EQUITY             

Current liabilities

            

Accounts payable

   $ 1,355,512      $ 767,615      $ (675,472   (I3)   $ 758,781  
           (688,874   (I4)  

Accrued legal fees

        3,500,000        (1,600,000   (I3)     1,900,000  

Accrued liabilities

     369,651        893,830        926,803     (I1)     1,074,427  
           1,304,473     (I2)  
           (1,350,000   (I3)  
           (1,042,800   (I4)  
           (27,530   (J1)  

Payable to related party

        1,610,875        (1,275,250   (F)     335,625  

Notes payable to related party

     705,000        1,564,673        230,887     (A2)     2,203,313  
           (297,247   (D2)  

Notes payable to related party at fair value

        1,506,389        (1,506,389   (DI)     —   

Notes payable

           3,338,824     (B2)     4,192,491  
           1,053,667     (B6)  
           (200,000   (J5)  

Derivative liability

           3,643,000     (B2)     3,643,000  

Other current liabilities

        79,162        (79,162   (A4)     —   

Deferred underwriting fee payable

        2,760,000        (2,760,000   (I3)     —   

Current maturities of long-term debt

     4,199,362           (3,130,854   (J1)     268,508  
           (800,000   (J4)  

Deferred revenue

     347,619               347,619  

Operating lease liabilities

     361,305               361,305  
  

 

 

    

 

 

    

 

 

     

 

 

 

Total current liabilities

     7,338,449        12,682,544        (4,935,924       15,085,069  

Long-term debt

     95,982               95,982  

Note payable to related party

     3,143,725               3,143,725  

Warrant liability

        7,950            7,950  

Earnout liability

           15,900,000     (J3)     15,900,000  

Operating lease liabilities

     1,062,633               1,062,633  

Other liabilities

     377,772               377,772  
  

 

 

    

 

 

    

 

 

     

 

 

 

Total liabilities

     12,018,561        12,690,494        10,964,076         35,673,131  
  

 

 

    

 

 

    

 

 

     

 

 

 

Common stock subject to possible redemption

        23,222,954        (9,356,221   (Al)     —   
           159,586     (A3)  
           (14,026,319   (C)  


PRO FORMA COMBINED BALANCE SHEET AS OF DECEMBER 31, 2023 (CONTINUED)

(unaudited)

 

     QT Imaging,
Inc.
    GigCapital5,
Inc.
    Pro Forma
Adjustments
        Pro Forma
Balance Sheet
 

Stockholders’ Deficit

          

Common Stock, $0.0001 par value

       655       20     (B4)     2,144  
         100     (B2)  
         43     (B3)  
         18     (B6)  
         126     (C)  
         9     (D1)  
         1     (B1)  
         122     (I3)  
         26     (I4)  
         36     (J1)  
         978     (J2)  
         10     (J5)  

Common Stock $0.001 par value

     27,941         (27,941   (H)     —   

Additional paid-in capital

     12,430,125       4,589,179       (159,586   (A3)     10,471,240  
         (1   (Bl)  
         499,980     (B4)  
         2,043,076     (B2)  
         1,508,940     (B3)  
         446,315     (B6)  
         14,026,193     (C)  
         943,631     (D1)  
         (18,094,569   (G)  
         27,941     (H)  
         3,759,878     (I3)  
         917,774     (I4)  
         3,233,352     (J1)  
         (978   (J2)  
         (15,900,000   (J3)  
         199,990     (J5)  

Accumulated deficit

     (17,770,145     (17,104,720     18,094,569     (G)     (32,350,155
         159,586     (A3)  
         (73,794   (A4)  
         (20,000   (B2)  
         (1,508,983   (B3)  
         (11,511,550   (B5)  
         6,389     (D1)  
         (107,032   (E)  
         (926,803   (I1)  
         (1,304,473   (I2)  
         (48,195   (I3)  
         (75,004   (J1)  
         (160,000   (J4)  
  

 

 

   

 

 

   

 

 

     

 

 

 

Total stockholders’ deficit

     (5,312,079     (12,514,886     (4,049,806       (21,876,771
  

 

 

   

 

 

   

 

 

     

 

 

 

TOTAL LIABILITIES, REDEEMABLE COMMON STOCK AND STOCKHOLDERS’ DEFICIT

   $ 6,706,482     $ 23,398,562     $ (16,308,684     $ 13,796,360  
  

 

 

   

 

 

   

 

 

     

 

 

 

Pro Forma Adjustments to the Unaudited Combined Balance Sheet

(A1) To reflect the March 2024 redemption of 848,003 shares of GigCapital5 common stock as if it had occurred as of December 31, 2023.

(A2) Reflects the additional proceeds received prior to the Closing of $230,887 under a promissory note with a related party of GigCaptial5 as if it had occurred as of December 31, 2023.

(A3) Reflects interest income of $159,586 earned by the trust account prior to the Closing as if it had occurred as of December 31, 2023.

(A4) Reflects amounts withdrawn from the trust account to pay taxes as if it had occurred as of December 31, 2023.


(A5) To reflect the release of $13,952,525 held in the Trust Account after giving effect to the March 2024 redemptions, including Q1 2024 interest received by and taxes withdrawn from the Trust Account as if it occurred as of December 31, 2023. All amounts held in the Trust Account were released upon the consummation of the Business Combination as if it occurred as of December 31, 2023.

(B1) To reflect cashless exercise of In-the-Money Company Warrants into 16,320 shares of QT Imaging Common Stock prior to the Closing as if the Closing had occurred on December 31, 2023. Upon consummation of the Business Combination, the shares of QT Imaging Common Stock were converted into 5,594 shares of Combined Company Common Stock. The terms of the In-the-Money Company Warrants have not been modified.

(B2) To reflect the net proceeds under the SEPA for a total of $10,000,000 issued in the form of a pre-paid advance from Yorkville and evidenced by a convertible promissory note. As consideration for the pre-paid advance and prior to the Business Combination, Yorkville received consideration that a holder of shares of QT Imaging Common Stock was entitled to receive pursuant to the Business Combination Agreement, including 1,000,000 shares of GigCapital5 Common Stock. The capitalized terms in this footnote are as defined in the SEPA.

The $10,000,000 promissory note was issued on March 4, 2024 pursuant to Section 2.01 of the SEPA, dated November 15, 2023, between the Company and the Holder. The note contained the following derivative features (“Derivatives”) that were recognized at fair value:

 

   

Monthly Payment Premium - If, any time after the Issuance Date, and from time to time thereafter, a Trigger Event occurs, then the Company shall make monthly payments of Triggered Principal Amount, Payment Premium and accrued and unpaid interest.

 

   

Monthly Payment Discount -If, any time after the Issuance Date, and from time to time thereafter, a Trigger Event occurs, then the Company shall make monthly payments of Triggered Principal Amount minus the lesser of (x) $1,500,000 and (y) such amount of fifty percent (50%) of the Investor’s net sales proceeds of the Company Shares or fifty percent (50%) of the value of the Company Shares on such date the cash payment is due.

 

   

Variable Price Conversion Right -Subject to certain limitations, at any time or times on or after the Issuance Date, the Holder shall be entitled to convert any portion of the outstanding and unpaid Conversion Amount into fully paid and nonassessable Common Stock in accordance with Section (3)(b), at the Conversion Price of 95% of the lowest VWAP of the Company’s Common Stock during the 5 consecutive Trading Days immediately preceding the Conversion Date or the date the Holder submits an Investor Notice pursuant to and as defined in the SEPA, as applicable, or other date of determination, but not lower than the Floor Price.

 

   

Failure to Timely Convert - If within three (3) Trading Days after the Company’s receipt of an email copy of a Conversion Notice the Company shall fail to issue and deliver a certificate to the Holder or credit the Holder’s balance account with DTC for the number of shares of Common Stock to which the Holder is entitled upon such holder’s conversion of any Conversion Amount (a “Conversion Failure”), and if on or after such Trading Day the Holder purchases (in an open market transaction or otherwise) Common Stock to deliver in satisfaction of a sale by the Holder of Common Stock issuable upon such conversion that the Holder anticipated receiving from the Company (a “Buy-In”), then the Company shall, within three (3) Business Days after the Holder’s request and in the Holder’s discretion, either (i) pay cash to the Holder in an amount equal to the Holder’s total purchase price (including brokerage commissions and other out of pocket expenses, if any) for the Common Stock so purchased (the “Buy-In Price”), or (ii) promptly honor its obligation to deliver to the Holder a certificate or certificates representing such Common Stock and pay cash to the Holder in an amount equal to the excess (if any) of the Buy-In Price over the product of (A) such number of shares of Common Stock, times (B) the Closing Price on the Conversion Date.

 

   

Corporate Events -In addition to and not in substitution for any other rights hereunder, prior to the consummation of any Fundamental Transaction pursuant to which holders of Common Stock are entitled to receive securities or other assets with respect to or in exchange for shares of Common Stock (a “Corporate Event”), the Company shall make appropriate provision to ensure that the Holder will thereafter have the right to receive upon a conversion of this Note, at the Holder’s option, (i) in addition to


 

the Common Stock receivable upon such conversion, such securities or other assets to which the Holder would have been entitled with respect to such Common Stock had such Common Stock been held by the Holder upon the consummation of such Corporate Event (without taking into account any limitations or restrictions on the convertibility of this Note) or (ii) in lieu of the Common Stock otherwise receivable upon such conversion, such securities or other assets received by the holders of Common Stock in connection with the consummation of such Corporate Event in such amounts as the Holder would have been entitled to receive had this Note initially been issued with conversion rights for the form of such consideration (as opposed to Common Stock) at a conversion rate for such consideration commensurate with the Conversion Price. Provision made pursuant to the preceding sentence shall be in a form and substance satisfactory to the Required Holders.

The fair value of the above Derivatives was calculated using a Monte Carlo simulation, performed by an independent valuation firm. The simulation used as significant inputs the volatility of QT Imaging equity that was derived based on a comparable peer group of publicly traded companies and the company’s stock price on the valuation date based on the $3.53 per share market price at the Closing date.

The key inputs into the valuation model included a volatility of 80%, risk-free rate of 5% and a fair value of the common stock at $3.53 per share.

The total value of the Derivatives reflected the combined value of the monthly payment premium, reduction to that premium by the payment discount, and the value of the conversion right. The values of the failure to timely convert and corporate event features were deemed to be de minimus.

In accordance with ASC 470-20, the proceeds of $10,000,000 will be recorded between the promissory note and Common Stock less debt origination costs of $975,000, consisting of a $375,000 commitment fee for the SEPA and original issue discount of 6% for the Pre-Paid Advance, on a relative fair value basis. A structuring fee of $20,000 will be expensed.

(B3) To reflect the issuance of the number of shares of QT Imaging Common Stock, as consideration for the September and December 2023 Non-Redemption Agreements (“NRA”) Stockholders agreeing not to redeem or to reverse any redemption demands previously submitted in connection with the respective extensions, that will convert into an aggregate of 427,477 of the Combined Company at a fair value of $3.53 per share after the Closing. The shares will be fully vested, nonforfeitable equity instruments upon issuance to the December 2023 NRA Stockholders and in connection with the September and December 2023 NRA that included no further obligation (of the September and December 2023 NRA Stockholders) after entering into the NRA. QT Imaging will recognize the issuance of the QT Imaging Common Stock as general & administrative expense in accordance with ASC 718-10.

(B4) To reflect the proceeds of $500,000 received under the Stock Subscription Agreements. Stock Subscription Agreements of $500,000 converted into an aggregate of 200,000 shares of the Combined Company after the Closing (i.e., at an implied conversion rate of $2.50 per share of Combined Company Common Stock).

(B5) To reflect the payment of the required non-redemption payments as defined in the November 2023 Non-Redemption Agreements for an aggregate of 1,200,000 shares not redeemed times the redemption price less $2.50 per share plus 50,000 structuring shares at the redemption price. QT Imaging will recognize the payment as general & administrative expense in accordance with ASC 718-10.

(B6) To reflect the issuance of Cable Car Promissory Note in the amount of $1,500,000 and the issuance of 180,000 shares of Combined Company in lieu of any simple or in-kind interest on the Closing. In accordance with ASC 470-20, the proceeds of $1,500,000 will be recorded between the promissory note and Common Stock on a relative fair value basis.

(C) To reflect the redemption of 848,003 shares by Public Stockholders of GigCapital5 at the Closing, 1,250,000 shares not redeemed and payments made under the November 2023 Non-Redemption Agreements. To reflect the transfer of the remaining 1,264,590 shares of the Common Stock to permanent equity ($14,026,319). See Note (B5) for payments made under the November 2023 Non-Redemption Agreements.


(D1) To reflect the payment of $556,360 of the $1,500,000 Working Capital Notes and conversion of the remaining $943,640 of the Working Capital Notes into 94,364 shares of the Combined Company Common Stock at the Closing.

(D2) To reflect the payment of the non-convertible Working Capital Notes ($297,247) at the Closing.

(E) To reflect the payment of certain expenses at the Closing as if the Closing, as if the Closing had occurred as of December 31, 2023.

(F) To reflect the payment of amounts due at the Closing to related parties and insiders of GigCapital5, as if the Closing had occurred as of December 31, 2023.

(G) To reflect the elimination of the historical accumulated deficit of GigCapital5, the accounting acquiree.

(H) Eliminates the historical par value of QT Imaging. The par value of the Combined Company Common Stock will be $0.0001 per share.

(I1) Reflects the recording of the estimated GigCapital5 Transaction Expenses and other closing costs not reflected in the historical statements. The accrual of $926,803 reflects total GigCapital5 Transaction Expenses and other closing costs of $8,512,490 less amounts already paid of $509,445 and amounts recorded in accounts payable of $216,242, accrued legal fees of $3,500,000, accrued advisory fees of $600,000 and deferred underwriting fees $2,760,000.

(I2) Reflects the recording of the estimated Company Transaction Expenses not reflected in the historical statements. The accrual of $1,304,473 reflects total estimated Company Transaction Expenses of $3,563,086 less $461,782 already paid and amounts already recorded in accounts payable of $785,089 and accrued liabilities of $24,729, and $987,013 of transaction costs related to D&O insurance that were prepaid on the date of the Closing.

(I3) Reflects the payment of Unpaid GigCapital5 Transaction Expenses and other closing Costs of $2,673,667 in cash at the Closing with the remaining $3,760,000 paid in Common Stock.

(I4) Reflects the payment of Unpaid Company Transaction Expenses and other closing costs of $1,800,887 in cash at the Closing with the remaining $917,800 was paid in Common Stock.

(J1) Reflects the conversion of certain QT Imaging Convertible Notes, including accrued interest payable, into 1,048,330 shares of QT Imaging Common Stock immediately prior to the Business Combination in accordance with the terms of such QT Imaging Convertible Notes with no gain or loss recorded upon conversion. At the Closing, the shares of QT Imaging Common Stock issued from the conversion of the QT Imaging Convertible Notes will be exchanged for 359,265 shares of the Combined Company Common Stock.

(J2) Reflects the remaining par value adjustment of shares of GigCapital5 Capital Stock issued to the holders of the QT Imaging Equity Securities.

(J3) Reflects the fair value of the Merger Consideration Earnout Shares pertaining to the holders of the QT Imaging Equity Securities at the Closing, as if the Closing had occurred as of December 31, 2023.

The Merger Consideration Earnout Shares will be released and delivered upon the occurrence of Triggering Events. In September 2023, the BCA was amended to move certain measurement dates for revenue from December 31, of each year to the following September 30 of the following year. In addition, the revenue trigger for the third measurement year was reduced from $67 million to $30 million, which, all else being equal, had the effect of increasing the estimated value of the Merger Consideration Earnout Shares. The period of measurement for the


revenue targets, as defined in the BCA, as amended, are for the 15 months ended September 30, 2024, and for each of the 12 months ended September 30, 2025, and 2026. In addition, management’s estimated probabilities of meeting the triggering events were lowered, from 25 percent, 75 percent and 90 percent, to 15 percent, 50 percent and 75 percent, which, all else being equal, had the effect of decreasing the estimated value of the Merger Consideration Earnout Shares.

The fair value of the Merger Consideration Earnout shares was calculated using a Monte Carlo simulation. The simulation used as significant inputs QT Imaging management’s current assessment of placements of breast scanning systems in 2024 and 2025, likely expected values for revenues from 2024 through 2026, probabilities for regulatory approvals including FDA clearances, and probabilities of other Triggering Events related to the open angle scanner. The probabilities of the non-revenue triggers generally range from 50 to 75 percent with the exception of the FDA clearance for a new indication November 14, 2025, as defined in the BCA, which is at 15 percent. The revenue forecast for the respective measurement periods are generally in line with the revenue triggers as defined in the BCA as amended. Additional significant inputs into the simulation include the volatility of QT Imaging equity, assets, and revenue that was derived in a manner as would be common for such simulation, and published industry operating profitability metrics. A weighted average cost of capital (“WACC”) was estimated based on a venture capital rates of return on debt and equity. This WACC was used as the discount rate applicable to revenue, after applying a delivering factor to convert it from being applicable to earnings before interest and tax (“EBIT”) to being applicable to revenue. This EBIT to revenue delivering factor was estimated using published industry operating profit and cost metrics.

The Monte Carlo simulation developed a distribution of projected revenues for 2024 through 2026 using a Geometric Brownian Motion framework based on a standard normal distribution of returns. The simulation also developed a distribution of potential daily Combined Company Common Stock prices for 2026 using a Geometric Brownian Motion framework, and the current traded market price of GigCapital5 Common Stock as the initial input. The resulting fair value is based on the average of the number of shares that will be paid out for each Triggering Event over a statistically significant number of simulations.

The significant assumptions included: An expected volatility of revenue of 21.0%; a discount rate applicable to revenue of 10.2%; a risk-free rate (revenue and equity model) of 4.5%; a risk premium of 5.7%; cost of debt of 22.0%; credit risk spread of 17.5%; and an equity volatility of 80.0%.”

(J4) Reflects the payment of four of the Senior Secured Convertible Notes issued by QT Imaging at 120 percent of the principal balance of $800,000 at the Closing as if the Closing occurred as of December 31, 2023.

(J5) Reflects the conversion of certain Senior Secured Convertible Notes issued by QT Imaging immediately prior to the Closing of the Business Combination into such number of validly issued, fully paid and non-assessable shares of QT Imaging Common Stock that upon the completion of the Business Combination and the application of the Exchange Ratio was exchanged for such consideration as was provided for in the Business Combination Agreement, including that number of shares of Combined Company Common Stock as was equal in the aggregate to 100,000 shares of Combined Company Common Stock. Upon conversion of aforementioned Senior Secured Convertible Notes, the unamortized associated deemed debt discount was fully expensed.


PRO FORMA CONDENSED COMBINED STATEMENTS OF OPERATIONS

FOR THE YEAR ENDED DECEMBER 31, 2023

(unaudited)

 

     QT Imaging, Inc.
(Historical)
    GigCapital5, Inc.
(Historical)
    Pro Forma
Adjustments
        Pro Forma
Statement of
Operations
 

Revenue

   $ 40,355     $ —      $ —        $ 40,355  

Cost of revenue

     134,988       —        —          134,988  
  

 

 

   

 

 

   

 

 

     

 

 

 

Gross profit

     (94,633     —        —          (94,633
  

 

 

   

 

 

   

 

 

     

 

 

 

Operating Expenses:

          

Research and development

     1,485,636       —        (105,255   (P)     1,380,381  

Selling, general, and administrative

     3,427,690       4,927,599       (604,139   (P)     23,989,972  
         11,511,550     (T)  
         1,508,983     (U)  
         3,218,289     (R)  
  

 

 

   

 

 

   

 

 

     

 

 

 

Total operating expenses

     4,913,326       4,927,599       (15,529,428       25,370,353  
  

 

 

   

 

 

   

 

 

     

 

 

 

Loss from operations

     (5,007,959     (4,927,599     (15,529,428       (25,464,986

Interest expense

     (544,826     (219,686     367,704     (Q)     (6,092,504
         (5,258,554   (Q1)  
         (437,142   (Q4)  

Interest income on marketable securities held in Trust Account

     —        1,526,860       (1,526,860   (O)     —   

Other income (expense)

     (544,566     14,953       8,897     (Q2)     43,726  
         20,000     (S)  
         544,442     (Q3)  
  

 

 

   

 

 

   

 

 

     

 

 

 

Loss before income tax expense

     (6,097,351     (3,605,472     (21,810,941       (31,513,764

Income tax expense

     1,600       419,119       (419,119   (O)     1,600  
  

 

 

   

 

 

   

 

 

     

 

 

 

Net loss

   $ (6,098,951   $ (4,024,591   $ (21,391,822     $ (31,515,364
  

 

 

   

 

 

   

 

 

     

 

 

 

Pro Forma Adjustments to the Unaudited Combined Statement of Operations

(O) Represents the elimination of interest income related to the investments in the GigCapital5 Trust Account as of the beginning of the period and the corresponding income tax expense.

(P) Reflects the reversal of stock-based compensation on QT Imaging Options and warrant expense, for other than In-The-Money Company Warrants, both of which are assumed to be cancelled as January 1, 2023.

(Q) Reflects the reversal of interest expense and amortization of the debt discount on QT Imaging Convertible Notes and Bridge Loans converted to QT Imaging Common Stock or repaid as of the beginning of the year as if the Business Combination was considered effective on January 1, 2023.

(Q1) Reflects $598,356 of accrued interest expense and $4,660,198 amortization of debt issuance costs of the Convertible Promissory Note issued to Yorkville over the 15-month period of the note entered into as if the Business Combination was considered effective on January 1, 2023.

(Q2) Reflects the reversal of the fair value adjustment on GigCapital5 Working Capital Notes as the notes are considered paid or converted as if the Business Combination was considered effective on January 1, 2023.

(Q3) Reflects the reversal of debt extinguishment loss for QT Imaging Convertible Notes and Related Party Notes that were amended in accordance with the terms of the Business Combination Agreement as if the Business Combination was considered effective on January 1, 2023.

(Q4) Reflects $437,142 of amortization of debt issuance costs of the Cable Car Promissory Note over a 13-month period and entered into as if the Business Combination was considered effective on January 1, 2023.


(R) Reflects the additional Unpaid GigCapital5 Transaction Expenses of $926,803 consisting of accrued legal fees and other accrued liabilities as reflected on the Pro Forma Combined Balance Sheet as of December 31, 2023, and Company Transaction Expenses of $2,291,486 consisting of accrued legal fees and other accrued liabilities as reflected on the Pro Forma Combined Balance Sheet as of December 31, 2023 not included in the historical numbers.

(S) Reflects $20,000 of structuring fee paid to Yorkville in accordance with the terms of the SEPA as if the Business Combination is considered effective on January 1, 2023.

(T) Reflects $11,511,550 of expense recognized for non-redemption payments as defined in the November 2023 Non-Redemption Agreements for an aggregate of 1,200,000 shares not redeemed times the redemption price less $2.50 per share plus 50,000 structuring shares at the redemption price as if the Business Combination is considered effective on January 1, 2023.

(U) Reflects $1,508,983 of expense for the issuance of the number of shares of QT Imaging Common Stock, as consideration for the September and December 2023 Non-Redemption Agreements (“NRA”) Stockholders agreeing not to redeem or to reverse any redemption demands previously submitted in connection with the respective extensions as if the Business Combination is considered effective on January 1, 2023.

 

     QT Imaging, Inc.
(Historical)
    GigCapital5, Inc.
(Historical)
    Pro Forma
Adjustments
    Pro Forma
Statement of
Operations
 

Net loss

   $ (6,098,951   $ (4,024,591   $ (21,391,822   $ (31,515,364

Weighted average Combined Company Common Stock shares outstanding - basic and diluted

     —        —        —        21,437,216  

Net loss per Combined Company Common Stock share - basic and diluted

     —        —        —      $ (1.47

Weighted average QT Imaging Common Stock shares outstanding - basic and diluted

     27,815,913       —        —        —   

Net loss per QT Imaging Common Stock share - basic and diluted

   $ (0.22     —        —        —   

Net income attributable to GigCapital5 Common Stock subject to possible redemption

     —      $ 1,107,741       —        —   

Weighted average GigCapital5 Common Stock subject to possible redemption shares outstanding - basic and diluted

     —        3,020,634       —        —   

Net income per share - GigCapital5 Common Stock subject to possible redemption - basic and diluted

     —      $ 0.37       —        —   

Net loss attributable to non-redeemable GigCapital5 common stockholders

     —      $ (5,132,332     —        —   

Weighted average non-redeemable GigCapital5 Common Stock shares outstanding - basic and diluted

     —        6,540,000       —        —   

Net loss per share - non-redeemable GigCapital5 Common Stock - basic and diluted

     —      $ (0.78     —        —   

PRO FORMA CHANGE IN EQUITY ACCOUNTS

(unaudited)

 

     Shares     %  

GigCapital5 Public Stockholders pre redemption

     2,114,978       9.9

Less: December 2023 partial redemption

     (2,385     0.0

Less: March 2024 partial redemption

     (848,003     (4.0 %) 
  

 

 

   

 

 

 

Total held by Public Stockholders (1)(2)

     1,264,590       5.9

Sponsor and insiders (3)

     6,540,000       30.5

Shares issued in conversion of GigCapital5 Working Capital Notes (4)

     94,364       0.4

Conversion of QT Imaging Converting Notes (5)

     393,535       1.8

Former holders of QT Imaging Common Stock in December 2022 excluding the Bridge Financing (6)

     9,373,733       43.7

Shares from QT Imaging Bridge Financing (6)

     167,923       0.8

Shares from cashless exercise of QT Imaging In-the-Money Company Warrants (7)

     5,594       0.0

Conversion of QT Imaging Bridge Loan convertible notes (8)

     100,000       0.5

Shares from the Stock Subscription Agreements (9)

     200,000       0.9

Shares as consideration for the Yorkville Pre-Paid Advance (10)

     1,000,000       4.7

Shares from the conversion of underwriter fees (11)

     740,000       3.5

Shares from the conversion of extension advisor fees (12)

     100,000       0.5

Shares from extension non-redemption agreements (13)

     427,477       2.0

Early Investor Consideration Shares (14)

     150,000       0.7

Shares issued in payment to QT Imaging financial advisor (15)

     250,000       1.2

Shares issued in conjunction with the Cable Car Promissory Note (16)

     180,000       0.8

Shares issued in payment of Transaction Expenses (17)

     450,000       2.1
  

 

 

   

 

 

 

Pro Forma Combined Company Common Stock outstanding at Closing (18)

     21,437,216       100.0
  

 

 

   

 

 

 

 

(1)

Amount is after giving effect to the redemption of 18,985,950 Public Shares in the September 2022 Partial Redemption, 995,049 Public Shares in the March 2023 Partial Redemption, 904,023 Public Shares in the September 2023 Partial Redemption, 2,385 Public Shares in the December 2023 Partial Redemption and 848,003 Public Shares in the March 2024 Partial Redemption. Of the 1,264,590 shares of GigCapital5 Common Stock held by Public Stockholders, 1,250,000 shares are not redeemable under the November 2023 Non-Redemption Agreements, resulting in only 14,590 shares of GigCapital5 Common Stock not covered under non-redemption agreements.


(2)

Amount excludes 23,000,000 outstanding Warrants and 795,000 private warrants which are a part of the Private Placement Units.

 

(3)

The Sponsor holds 5,735,000 Founder Shares, and an additional 795,000 shares of GigCapital5 Common Stock that are a constituent security of the Private Placement Units. There are 10,000 shares of GigCapital5 Common Stock in the aggregate held an affiliate of ICR.

 

(4)

The Sponsor holds a total of $1,500,000 of GigCapital5 Working Capital Notes that are convertible, at the Sponsor’s election, at a price of $10.00 per unit, into units identical to the Private Placement Units issued in connection with GigCapital5’s initial public offering. The Sponsor converted at the Closing $943,640 of the $1,500,000 principal balance into 94,364 units, which were then separated into 94,364 shares of Combined Company Common Stock and 94,364 private warrants. The 94,364 private warrants are excluded from the table.

 

(5)

Conversion into shares of the Combined Company Common Stock of shares of QT Imaging Common Stock related to QT Imaging Converting Notes to be converted into 1,148,330 shares of QT Imaging Common Stock immediately prior to the Merger. At the Closing, the shares of QT Imaging Common Stock issued from the conversion of the QT Imaging Converting Notes will be exchanged for 393,535 shares of the Combined Company Common Stock.

(6)

As of December 2023, the former holders of QT Imaging Common Stock included the holders of 27,941,290 shares of QT Imaging Common Stock, which will be exchanged for 9,373,733 shares of Combined Company Common Stock at the Closing, and participants in the Bridge Financing, who acquired 490,000 shares of QT Imaging Common Stock, which will be exchanged for 167,923 shares of Combined Company Common Stock at the Closing.

 

(7)

Amount assumes all In-the-Money Company Warrants for the purchase of 60,329 shares of QT Imaging Common Stock will net settle for 16,320 shares of QT Imaging Common Stock immediately prior to the Merger and convert into 5,594 shares of the Combined Company.

 

(8)

Conversion into shares of the Combined Company Common Stock of shares of QT Imaging Common Stock related to $200,000 in convertible notes issued in the November 2023 $1 million Bridge Loan to be converted into 291,798 shares of QT Imaging Common Stock immediately prior to the Merger. At the Closing, the shares of QT Imaging Common Stock issued from the conversion of the convertible notes issued in the Bridge Loan will be exchanged for 100,000 shares of the Combined Company Common Stock.

 

(9)

Only one subscriber to the Stock Subscription Agreements purchased shares of QT Imaging for $500,000 pursuant to the terms of the Stock Subscription Agreements and the remaining three subscribers held an aggregate of 1,250,000 shares of GigCapital5 Common Stock under the November 2023 Non-Redemption Agreements. At the Closing, the shares of QT Imaging Common Stock will be exchanged for 200,000 shares of the Combined Company Common Stock.

 

(10)

The consideration to Yorkville for the Pre-Paid Advance consists of shares of QT Imaging Common Stock equal to that number of shares that will result in Yorkville as a stockholder of QT Imaging receiving pursuant to the Business Combination Agreement 1,000,000 shares of Combined Company Common Stock.

 

(11)

As partial consideration for the deferred underwriter fees, William Blair has agreed to receive shares of QT Imaging Common Stock equal to that number of shares that will result in William Blair as a stockholder of QT Imaging receiving pursuant to the Business Combination Agreement 740,000 shares of Combined Company Common Stock.

 

(12)

As consideration for advisory fees in connection with an extension, an advisor has agreed to receive shares of QT Imaging Common Stock equal to that number of shares that will result in such advisor as a stockholder of QT Imaging receiving pursuant to the Business Combination Agreement 100,000 shares of Combined Company Common Stock.

 

(13)

As consideration for the September 2023 Non-Redemption Agreements and the December 2023 Non-Redemption Agreements, the parties to such agreements have agreed to receive shares of QT Imaging Common Stock equal to that number of shares that will result in such parties as stockholders of QT Imaging receiving pursuant to the Business Combination Agreement at least 427,477 shares of Combined Company Common Stock.


(14)

Shares of QT Imaging Common Stock to be issued to subscribers to the Stock Subscription Agreements entered into in November 2023 equal to that number of shares that will result in such parties as stockholders of QT Imaging receiving pursuant to the Business Combination Agreement 150,000 shares of Combined Company Common Stock.

 

(15)

As partial consideration for advisory fees, a financial advisor to QT Imaging has agreed to receive shares of QT Imaging Common Stock equal to that number of shares that will result in such financial advisor as a stockholder of QT Imaging receiving pursuant to the Business Combination Agreement 250,000 shares of Combined Company Common Stock.

 

(16)

The issuance on the Closing of 180,000 shares of Combined Company in lieu of any simple or in-kind interest in conjunction with the issuance of Cable Car Promissory Note in the amount of $1,500,000. In accordance with ASC 470-20, the proceeds of $1,500,000 will be recorded between the promissory note and Common Stock on a relative fair value basis.

 

(17)

In consideration for the settlement of certain liabilities for various services rendered, the parties to the agreements have agreed to accept an aggregate of 450,000 shares of the Combined Company in lieu of cash payments.

 

(18)

After consummation of the proposed Business Combination, the former holders of QT Imaging Equity Securities will have the contingent rights to receive 9,000,000 Merger Consideration Earnout Shares. The contingently issuable Merger Consideration Earnout Shares are excluded from the expected shares issued to the former holders of QT Imaging Equity Securities above as they will not be issued at the Closing due to the contingencies associated with the earnout.