SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person*
Zannes Timothy P

(Last) (First) (Middle)
1510 VISTA LARGA CT. NE

(Street)
ALBUQUERQUE NM 87106

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
08/29/2022
3. Issuer Name and Ticker or Trading Symbol
bioAffinity Technologies, Inc. [ BIAF ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Secretary, EVP, Gen. Counsel
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Stock Option (right to buy)(1) (2) 04/28/2024 Common Stock 64,848 $1.16 D
Stock Option (right to buy)(1) (3) 04/24/2027 Common Stock 1,428 $7 D
Stock Option (right to buy)(1) (4) 05/07/2028 Common Stock 4,285 $7.7 D
Stock Option (right to buy)(1) (5) 02/25/2029 Common Stock 2,142 $7.7 D
Stock Option (right to buy)(1) (6) 02/05/2030 Common Stock 2,142 $7.7 D
Stock Option (right to buy)(1) (7) 07/26/2031 Common Stock 2,142 $7.7 D
Explanation of Responses:
1. The number of securities and exercise prices reported in this Form 3 reflect the 1-for-7 reverse stock split of the common stock, par value $0.007 (the "Common Stock"), of bioAffinity Technologies, Inc. (the "Issuer"), which became effective with the State of Delaware on June 23, 2022 in connection with the Issuer's initial public offering.
2. Represents a right to purchase 64,848 shares of Common Stock upon exercise of a ten-year option granted to Mr. Zannes under the Issuer's 2014 Equity Incentive Plan (the "EIP") on April 28, 2014. This option vested in 7 monthly installments beginning on May 28, 2014 and is fully vested and exercisable as of the date of this report.
3. Represents a right to purchase 1,428 shares of Common Stock upon exercise of a ten-year option granted to Mr. Zannes under the EIP on April 24, 2017. This option vested in 12 monthly installments beginning on May 24, 2017 and is fully vested and exercisable as of the date of this report.
4. Represents a right to purchase 4,285 shares of Common Stock upon exercise of a ten-year option granted to Mr. Zannes under the EIP on May 7, 2018. This option vested in 12 monthly installments beginning on June 7, 2018 and is fully vested and exercisable as of the date of this report.
5. Represents a right to purchase 2,142 shares of Common Stock upon exercise of a ten-year option granted to Mr. Zannes under the EIP on February 25, 2019. This option vested in 12 monthly installments beginning on March 25, 2019 and is fully vested and exercisable as of the date of this report.
6. Represents a right to purchase 2,142 shares of Common Stock upon exercise of a ten-year option granted to Mr. Zannes under the EIP on February 5, 2020. This option vested in 12 monthly installments beginning on March 5, 2020 and is fully vested and exercisable as of the date of this report.
7. Represents a right to purchase 2,142 shares of Common Stock upon exercise of a ten-year option granted to Mr. Zannes under the EIP on July 26, 2021. This option vested in 12 monthly installments beginning on August 26, 2021 and is fully vested and exercisable as of the date of this report.
Remarks:
Exhibit List - Exhibit 24.1: Power of Attorney (Timothy P. Zannes)
/s/ Wilhelm E. Liebmann, as attorney-in-fact for Timothy P. Zannes 12/05/2022
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
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