SEC FORM 3 SEC Form 3
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*
BAYER HEALTHCARE LLC

(Last) (First) (Middle)
100 BAYER BOULEVARD

(Street)
WHIPPANY NJ 07981

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
06/15/2023
3. Issuer Name and Ticker or Trading Symbol
Azitra Inc [ AZTR ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director X 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)
Form filed by One Reporting Person
X 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
Series B Convertible Preferred Stock (1) (1) Common Stock 1,307,401(2) (1) D(3)
1. Name and Address of Reporting Person*
BAYER HEALTHCARE LLC

(Last) (First) (Middle)
100 BAYER BOULEVARD

(Street)
WHIPPANY NJ 07981

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Bayer US Holding LP

(Last) (First) (Middle)
100 BAYER BOULEVARD

(Street)
WHIPPANY NJ 07981

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Bayer World Investments B.V.

(Last) (First) (Middle)
SIRIUSDREEF 36

(Street)
HOOFDDORP P7 2132WT

(City) (State) (Zip)
1. Name and Address of Reporting Person*
BAYER AKTIENGESELLSCHAFT

(Last) (First) (Middle)
BAYERWERK, GEBAEUDE W11
KAISER-WILHELM-ALLEE 1

(Street)
LEVERKUSEN 2M 51373

(City) (State) (Zip)
Explanation of Responses:
1. Each share of Series B Convertible Preferred Stock will automatically convert into one share of common stock upon the closing of the Issuer's IPO. Each share of Series B Convertible Preferred Stock has no expiration date.
2. The number of shares represented reflects a forward stock split at a ratio of 7.1-for-1 which was effectuated upon the effectiveness of the Issuer's Form S-1 (File No. 333-269876).
3. The securities reported are held directly by Bayer HealthCare LLC, a Delaware limited liability company, which is controlled by Bayer US Holding LP ("BUSH LP"), a Delaware limited partnership. Bayer World Investments B.V. ("BWI"), a Dutch private limited company, is the general partner of BUSH LP. BWI is an indirect, wholly owned subsidiary of Bayer Aktiengesellschaft, a publicly-held German stock corporation. Accordingly, Bayer Aktiengesellschaft may be deemed to be an indirect beneficial owner of the shares beneficially owned directly by Bayer HealthCare LLC.
Bayer HealthCare LLC, By: /s/ Keith Abrams, Name: Keith Abrams, Title: Assistant Secretary 07/21/2023
Bayer US Holding LP, By: /s/ Keith Abrams, Name: Keith Abrams, Title: VP, Head of Corp. Law and Asst. Secretary 07/21/2023
Bayer World Investments B.V., By: /s/ Kati Schnuerer, Name: Kati Schnuerer, Title: Managing Director 07/21/2023
Bayer Aktiengesellschaft, By: /s/ Deny-Jean Silny, Name: Deny-Jean Silny, Title: Head of Legal M&A 07/21/2023
** 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 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).
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