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Form 3 bioAffinity Technologies For: Aug 29 Filed by: Anderson Robert A.

December 2, 2022 9:28 PM EST

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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 *
Anderson Robert A.

(Last) (First) (Middle)
84 EDGEFIELD DRIVE

(Street)
MORRIS PLAINS NJ 07950

(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)
X Director 10% Owner
Officer (give title below) Other (specify below)
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) 07/27/2025 Common Stock 3,571 4.2 D  
Stock Option (right to buy) (1)   (4) 07/25/2026 Common Stock 3,571 7 D  
Stock Option (right to buy) (1)   (5) 04/24/2027 Common Stock 3,571 7 D  
Stock Option (right to buy) (1)   (6) 05/07/2028 Common Stock 7,142 7.7 D  
Stock Option (right to buy) (1)   (7) 07/29/2029 Common Stock 7,142 7.7 D  
Stock Option (right to buy) (1)   (8) 07/27/2030 Common Stock 7,142 7.7 D  
Stock Option (right to buy) (1)   (9) 12/16/2031 Common Stock 7,142 4.2 D  
Explanation of Responses:
1. The number of securities and exercise price 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 (the "IPO").
2. Represents a right to purchase 64,848 shares of Common Stock upon exercise of a ten-year option granted to Mr. Anderson 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 3,571 shares of Common Stock upon exercise of a ten-year option granted to Mr. Anderson under the EIP on July 27, 2015. This option vested in 12 monthly installments beginning on August 27, 2015 and is fully vested and exercisable as of the date of this report.
4. Represents a right to purchase 3,571 shares of Common Stock upon exercise of a ten-year option granted to Mr. Anderson under the EIP on July 25, 2016. This option vested in 12 monthly installments beginning on August 25, 2016 and is fully vested and exercisable as of the date of this report.
5. Represents a right to purchase 3,571 shares of Common Stock upon exercise of a ten-year option granted to Mr. Anderson 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.
6. Represents a right to purchase 7,142 shares of Common Stock upon exercise of a ten-year option granted to Mr. Anderson 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.
7. Represents a right to purchase 7,142 shares of Common Stock upon exercise of a ten-year option granted to Mr. Anderson under the EIP on July 29, 2019. This option vested in 12 monthly installments beginning on August 29, 2019 and is fully vested and exercisable as of the date of this report.
8. Represents a right to purchase 7,142 shares of Common Stock upon exercise of a ten-year option granted to Mr. Anderson under the EIP on July 27, 2020. This option vested in 12 monthly installments beginning on August 27, 2020 and is fully vested and exercisable as of the date of this report.
9. Represents a right to purchase 7,142 shares of Common Stock upon exercise of a ten-year option granted to Mr. Anderson under the EIP on December 16, 2021. On January 16, 2022, this option began vesting in 12 monthly installments, the first 11 of which are of 595 shares of Common Stock and the last of which is of the remaining 597 shares of Common Stock, subject to Mr. Anderson's continuous service to the Issuer through each vesting date. As of the date of this report, 4,760 shares of Common Stock underlying this option have vested. The remaining unvested shares of Common Stock will vest immediately prior to the closing of the IPO on September 6, 2022.
Remarks:
Exhibit 24.1: Power of Attorney (Robert Anderson)
/s/ Wilhelm E. Liebmann, as attorney-in-fact for Robert Anderson 12/02/2022
** 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 4 (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.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.

ATTACHMENTS / EXHIBITS

ex24-1.htm



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