SEC FORM 4 SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

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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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
SOO B CHIA

(Last) (First) (Middle)
C/O BONE BIOLOGICS CORPORATION
321 COLUMBUS AVENUE

(Street)
BOSTON MA 02116

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
Bone Biologics Corp [ NONE ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
09/19/2014
4. 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 Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 09/19/2014 J(1) 1,000,000 A (1) 1,000,000 D
Common Stock 2,000,000(2)(3) I By Spouse(2)(3)
Common Stock 09/19/2015 A 31,646(4) A $0.00(4) 1,031,646 D
Common Stock 10/09/2015 S 52,744(5) D $1.58 978,902 D
Common Stock 10/22/2015 G(6) V 2,000,000 D $0.00 0(3) I By Spouse(2)(3)
Common Stock 10/22/2015 G(6) V 2,000,000 A $0.00 2,978,902 D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Warrant (Right to Buy) $0.44 09/19/2014 J(7) 119,318 (8) 09/19/2024 Common Stock 119,318 (7) 119,318 D
Common Stock (Right to Acquire) $0.00 10/02/2015 A 384,615.33 (9) (9) Common Stock 384,615.33 $0.00 384,615.33 D
Explanation of Responses:
1. Represents shares of Common Stock of the Issuer issued pursuant to that certain Agreement and Plan of Merger (the "Merger Agreement"), dated as of September 19, 2014 by and among AFH Acquisition X, Inc., Bone Biologics, Inc. and Bone Biologics Acquisition Corp. Pursuant to the terms of the Merger Agreement each share of Common Stock of Bone Biologics, Inc. was converted into the same number of shares of the Issuer's Common Stock.
2. These shares are owned by Kang Ting. Dr. Ting is the spouse of the Reporting Person. The Reporting Person disclaims beneficial ownership of these securities, and this report shall not be deemed an admission that the Reporting Person is the beneficial owner of such securities for purposes of Section 16 or for any other purpose.
3. Does not include 384,615.33 shares of Common Stock issuable to Dr. Ting on the earlier of September 24, 2018 and the occurrence of certain events described in a letter agreement by and between the Issuer and the Reporting Person dated September 24, 2015 and attached as Exhibit 10.1 to Form 8-K filed with the Securities and Exchange Commission on October 8, 2015.
4. These shares were acquired by the Reporting Person pursuant to Reporting Person's non-employee director offer letter with the Issuer.
5. These shares were sold by the Reporting Person in a private transaction.
6. This transaction involved a gift of the shares of Common Stock owned by Dr. Ting to the Reporting Person.
7. On February 4, 2010, the Reporting Person acquired a warrant to purchase 119,318 shares of Common Stock of Bone Biologics, Inc.at an exercise price of $0.44 per share. Pursuant to the Merger Agreement, this warrant was converted into a warrant to purchase 119,318 shares of the Issuer's Common Stock at a per share exercise price of $0.44. The warrant is fully vested and exercisable.
8. Immediately exercisable.
9. Issuable to the Reporting Person on the earlier of September 24, 2018 and the occurrence of certain events described in a letter agreement by and between the Issuer and the Reporting Person dated September 24, 2015 and attached as Exhibit 10.1 to Form 8-K filed with the Securities and Exchange Commission on October 8, 2015.
Remarks:
/s/Chia Soo 12/18/2015
** 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).
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