Ownership Submission
|
FORM 3
|
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549INITIAL 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
|
|
OMB APPROVAL
|
|
OMB Number:3235-0104Expires:January 31, 2005Estimated average burden hours per response...0.5
|
|
|
1. Name and Address of Reporting Person *
|
|
Busch Jeffrey
|
|
2. Date of Event Requiring Statement (Month/Day/Year)
2024-09-19
|
3. Issuer Name and Ticker or Trading Symbol
IMAC Holdings, Inc. [BACK]
|
|
(Last)
|
(First)
|
(Middle)
|
|
C/O IMAC HOLDINGS, INC. , 3401 MALLORY LANE SUITE 100
|
|
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 Original Filed(Month/Day/Year)
|
(Street)
|
|
FRANKLIN
|
TN
|
37067
|
|
6. Individual or Join/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
|
2. Amount of Securities Beneficially Owned
|
3. Ownership Form: Direct (D) or Indirect (I)
|
4. Nature of Indirect Beneficial Ownership
|
|
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
|
1. Title of Derivate Security
|
2. Date Exercisable and Expiration Date
|
3. Title and Amount of Securities Underlying Derivative Security
|
4. Conversion or Exercise Price of Derivative Security
|
5. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
|
6. Nature of Indirect Beneficial Ownership
|
|
Date Exercisable
|
Expriation Date
|
Title
|
Amount or Number of Shares
|
Reporting Owners
|
Reporting Owner Name / Address
|
Relationships
|
|
Director
|
10% Owner
|
Officer
|
Other
|
Busch Jeffrey
C/O IMAC HOLDINGS, INC.
3401 MALLORY LANE SUITE 100
FRANKLIN, TN37067
|
X
|
|
|
|
Signatures
|
/s/ Jeffrey Busch
|
2024-10-07
|
|
**Signature of Reporting Person
|
Date
|
Explanation of Responses:
|
(*)
|
If the form is filed by more than one reporting person, see Instruction 5(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).
|
|
(1)
|
The shares of Series C-1 Preferred Convertible Preferred Stock, par value $0.001 per share (the "Series C-1 Preferred Stock") are immediately convertible into shares of the Issuer's common stock, par value $0.001 per share (the "Common Stock").
|
|
(2)
|
The Series C-1 Preferred Stock is perpetual and therefore has no expiration.
|
|
(3)
|
The Reporting Person owns 265 shares of Series C-1 Preferred Stock, which shares are currently convertible into 108,420 shares of Common Stock. However, the Series C-1 Preferred Stock is subject to a beneficial ownership cap that prohibits the conversion of the Series C-1 Preferred Stock into shares of Common Stock to the extent that such conversion would cause the reporting person's beneficial ownership, together with its affiliates, to exceed 9.99%.
|
|
(4)
|
The conversion price is subject to adjustment from time to time.
|
|
(5)
|
The shares of Series E Preferred Convertible Preferred Stock, par value $0.001 per share (the "Series E Preferred Stock") are immediately convertible into shares of the Common Stock.
|
|
(6)
|
The Series E Preferred Stock is perpetual and therefore has no expiration.
|
|
(7)
|
The Reporting Person owns 1,641 shares of Series E Preferred Stock, which shares are currently convertible into 456,335 shares of Common Stock. However, the Series E Preferred Stock is subject to a beneficial ownership cap that prohibits the conversion of the Series E Preferred Stock into shares of Common Stock to the extent that such conversion would cause the reporting person's beneficial ownership, together with its affiliates, to exceed 9.99%.
|
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient,
See Instruction 6 for procedure.Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB number.
