Amended Statement of Ownership (sc 13g/a)
15 February 2023 - 08:41AM
Edgar (US Regulatory)
SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, DC 20549
SCHEDULE 13G
(Rule 13d-102)
INFORMATION TO BE INCLUDED IN STATEMENTS FILED
PURSUANT
TO § 240.13d-1(b), (c) AND (d) AND
AMENDMENTS THERETO FILED
PURSUANT TO § 240.13d-2
(Amendment No. 1)*
Angion Biomedica Corp.
(Name of Issuer)
Common Stock
(Title of Class of Securities)
03476J107
(CUSIP Number)
December 31, 2022
(Date of Event Which Requires Filing of this
Statement)
Check the appropriate box to designate the rule pursuant to which
this Schedule is filed:
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The remainder of this cover page shall be filled out
for a reporting person’s initial filing on this form with respect
to the subject class of securities, and for any subsequent
amendment containing information which would alter the disclosures
provided in a prior cover page.
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The information required in the remainder of this cover page shall
not be deemed to be “filed” for the purpose of Section 18 of
the Securities Exchange Act of 1934 (“Act”) or otherwise subject to
the liabilities of that section of the Act but shall be subject to
all other provisions of the Act (however, see the Notes).
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CUSIP No. 03476J107 |
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13G |
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Page 2 of 6
Pages |
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1. |
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NAME OF REPORTING PERSONS
Itzhak D. Goldberg
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2. |
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CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP
(a) ☐
(b) ☐
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3. |
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SEC USE ONLY
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4. |
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CITIZENSHIP OR PLACE OF ORGANIZATION
USA
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NUMBER OF
SHARES
BENEFICIALLY
OWNED BY
EACH
REPORTING
PERSON
WITH
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5. |
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SOLE VOTING POWER
1,809,294*
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6. |
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SHARED VOTING POWER
0
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7. |
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SOLE DISPOSITIVE VOTING POWER
1,809,294*
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8. |
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SHARED DISPOSITIVE VOTING POWER
0
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9. |
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AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING
PERSON
1,809,294
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10. |
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CHECK IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES
CERTAIN SHARES
☐
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11. |
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PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9
6.0%**
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12. |
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TYPE OF REPORTING PERSON
IN
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* |
Consists of (1) 1,687,986 shares of Common Stock
held directly by the Reporting Person, and (2) 121,308 shares
of Common Stock underlying options exercisable within sixty days.
Numbers of shares are reported as of February 8, 2023.
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** |
Based on 30,113,703 shares of Common Stock issued and
outstanding as of November 8, 2022, as reported by the Issuer
in its most recent Form 10-K filed November 14, 2022.
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CUSIP No. 03476J107 |
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13G |
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Page 3 of 6
Pages |
Item 1(a). |
Name of Issuer:
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Angion Biomedica Corp.
Item 1(b). |
Address of Issuer’s Principal Executive
Offices:
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51 Charles Lindbergh Boulevard, Uniondale, NY 11553
Item 2(a). |
Name of Person Filing:
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This Schedule 13G is being filed by Itzhak D. Goldberg (the
“Reporting Person”).
Item 2(b). |
Address of Principal Business Office, or if None,
Residence:
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41 Brayton Street
Englewood, NJ 07631
The Reporting Person is a citizen of the United States.
Item 2(d). |
Title of Class of Securities:
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Common Stock, par value $0.01 per share (“Common Stock”)
03476J107
Item 3. |
If this statement is filed pursuant to §§
240.13d-1(b), or
240.13d-2(b) or (c), check
whether the person filing is a:
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(a) |
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Broker or dealer registered under Section 15
of the Act (15 U.S.C. 78o); |
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(b) |
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Bank as defined in Section 3(a)(6) of the Act
(15 U.S.C. 78c); |
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(c) |
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Insurance company as defined in
Section 3(a)(19) of the Act (15 U.S.C. 78c); |
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(d) |
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Investment company registered under Section 8
of the Investment Company Act of 1940 (15 U.S.C. 80a-8); |
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(e) |
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An investment adviser in accordance with §
240.13d-1(b)(1)(ii)(E); |
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(f) |
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An employee benefit plan or endowment fund in
accordance with § 240.13d-1(b)(1)(ii)(F); |
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(g) |
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A parent holding company or control person in
accordance with § 240.13d-1(b)(1)(ii)(G); |
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(h) |
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A savings association as defined in
Section 3(b) of the Federal Deposit Insurance Act (12 U.S.C.
1813); |
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(i) |
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A church plan that is excluded from the definition
of an investment company under Section 3(c)(14) of the
Investment Company Act (15 U.S.C. 80a-3); |
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(j) |
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A non-U.S.
institution in accordance with § 240.13d-1(b)(1)(ii)(J); |
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(k) |
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Group, in accordance with § 240.13d-1(b)(1)(ii)(K). |
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CUSIP No. 03476J107 |
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13G |
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Page 4 of 6
Pages |
Provide the following information regarding the aggregate number
and percentage of the class of securities of the issuer identified
in Item 1.
Reference is made to Items 5-9 and 11 and the footnotes thereto on
page 2 of this Schedule 13G, which are incorporated by reference
herein.
Item 5. |
Ownership of Five Percent or Less of a
Class.
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If this statement is being filed to report the fact that as of the
date hereof the reporting person has ceased to be the beneficial
owner of more than five percent of the class of securities check
the following ☐.
Item 6. |
Ownership of More Than Five Percent on Behalf of
Another Person.
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If any other person is known to have the right to receive or the
power to direct the receipt of dividends from, or the proceeds from
the sale of, such securities, a statement to that effect should be
included in response to this item and, if such interest relates to
more than five percent of the class, such person should be
identified. A listing of the shareholders of an investment company
registered under the Investment Company Act of 1940 or the
beneficiaries of employee benefit plan, pension fund or endowment
fund is not required.
Not Applicable.
Item 7. |
Identification and Classification of the Subsidiary
Which Acquired the Security Being Reported on by the Parent Holding
Company or Control Person.
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If a parent holding company or control person has filed this
schedule, pursuant to § 240.13d-1(b)(1)(ii)(G), so indicate
under Item 3(g) and attach an exhibit stating the identity and the
Item 3 classification of the relevant subsidiary. If a parent
holding company or control person has filed this schedule pursuant
to Rule 13d-1(c) or Rule
13d-1(d), attach an exhibit
stating the identification of the relevant subsidiary.
Not Applicable.
Item 8. |
Identification and Classification of Members of the
Group.
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If a group has filed this schedule pursuant to § 240.13d-1(b)(1)(ii)(J), so indicate
under Item 3(j) and attach an exhibit stating the identity and Item
3 classification of each member of the group. If a group has filed
this schedule pursuant to Rule 13d-1(c) or Rule 13d-1(d), attach an exhibit stating the
identity of each member of the group.
Not Applicable.
Item 9. |
Notice of Dissolution of Group.
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Notice of dissolution of a group may be furnished as an exhibit
stating the date of the dissolution and that all further filings
with respect to transactions in the security reported on will be
filed, if required, by members of the group, in their individual
capacity. (See Item 5.)
Not Applicable.
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CUSIP No. 03476J107 |
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13G |
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Page 5 of 6
Pages |
Not Applicable.
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CUSIP No. 03476J107 |
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13G |
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Page 6 of 6
Pages |
SIGNATURE
After reasonable inquiry and to the best of my knowledge and
belief, I certify that the information set forth in this statement
is true, complete and correct.
February 14, 2023
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By: |
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/s/ Itzhak D. Goldberg
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Itzhak D. Goldberg |
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