Immix Biopharma, Inc. — Director's Dealing 2021

Dec 20, 2021

SEC Form 4 — Statement of Changes in Beneficial Ownership

Issuer: Immix Biopharma, Inc. (IMMX)
CIK: 0001873835
Period of Report: 2021-12-20

Reporting Person: Hsu Jason (Director)

Non-Derivative Transactions

Date	Security	Code	Shares	Price	A/D	Holdings After	Ownership
2021-12-20	Common Stock	C	3915913	$0.85	Acquired	3915913	Indirect
2021-12-20	Common Stock	P	50000	$5.00	Acquired	50000	Indirect

Derivative Transactions

Date	Security	Exercise Price	Code	Shares	A/D	Expiration	Underlying	Ownership
2021-12-20	Convertible Note	$0.85	C		Disposed		Common stock (3915913)	Indirect

Footnotes

F1: Jason Hsu is the Sole Member of VERITAS LIBERABIT VOS, LLC ("VL") and in such capacity has the right to vote and dispose of the securities held by such entity.

F2: Jason Hsu is the Sole Member of Signature Collection Properties, LLC and in such capacity has the right to vote and dispose of the securities held by such entity.

F3: On September 1, 2016, the Registrant issued VL a note in the amount of $3 million which is payable upon request of the majority holders of like tenure notes on or after March 31, 2022. Pursuant to the terms of the note, because the Registrant sold equity securities in its initial public offering resulting in proceeds of at least $10 million, the note automatically converted into shares of the Registrant's common stock.