Initial Statement of Beneficial Ownership (3)
February 14 2022 - 03:32PM
Edgar (US Regulatory)
FORM 3
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0104
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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
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Ugwumba Chidozie |
2. Date of Event Requiring Statement (MM/DD/YYYY)
12/31/2021
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3. Issuer Name and Ticker or Trading Symbol
BiomX Inc. [PHGE]
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(Last)
(First)
(Middle)
609 SW 8TH STREET, SUITE 365 |
4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
_____ Director ___X___ 10% Owner _____ Officer (give title below) _____ Other (specify below)
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(Street)
BENTONVILLE, AR 72712
(City)
(State)
(Zip)
| 5. If Amendment, Date Original Filed(MM/DD/YYYY)
| 6. Individual or Joint/Group Filing(Check Applicable Line)
_X_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Beneficially Owned
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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) |
Common Stock | 3637846 (1)(2) | I | By SymBiosis, LLC |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security (Instr. 4) | 2. Date Exercisable and Expiration Date (MM/DD/YYYY) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form of Derivative Security: 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 |
Warrants to purchase Common Stock | 1/28/2022 | 1/28/2027 | Common Stock | 1875000 (1)(2) | $5 | I | By SymBiosis, LLC |
Explanation of Responses: |
(1) | The shares are directly held by SymBiosis, LLC. Previously, the beneficial owner of these shares was Thomas Layton Walton, by virtue of his sole voting power and dispositive power through SymBiosis, LLC. Although SymBiosis, LLC continues to hold these shares directly and Thomas Layton Walton continues to hold his pecuniary interest in these shares, the reporting person now exercises sole voting power and dispositive power through SymBiosis, LLC through a transition of that power to the reporting person (and not through a sale or other transfer of these shares). |
(2) | These shares beneficially owned by the reporting person include (i) 1,137,846 shares of common stock already owned by SymBiosis, LLC prior to July 28, 2021, (ii) 2,500,000 shares of common stock owned by SymBiosis, LLC that were purchased in the registered direct offering by BiomX Inc. that closed on July 28, 2021 and (iii) warrants (to purchase 1,875,000 shares of common stock) owned by SymBiosis, LLC that were purchased in the registered direct offering by BiomX Inc. that closed on July 28, 2021. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Ugwumba Chidozie 609 SW 8TH STREET SUITE 365 BENTONVILLE, AR 72712 |
| X |
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Signatures
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/s/ Chidozie Ugsumba | | 2/13/2022 |
**Signature of Reporting Person | Date |
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