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AMIX Insider Filing: Christopher Capelli Option Cancelled, No Consideration

Filing Impact
(Neutral)
Filing Sentiment
(Neutral)
Form Type
4

Rhea-AI Filing Summary

Autonomix Medical, Inc. (AMIX) Form 4 reports that Director Christopher Capelli had a stock option cancelled by mutual agreement on 08/11/2025. The option covered 3,750 underlying shares and showed an adjusted exercise price of $40 following a 1-for-20 reverse stock split. The option was listed as exercisable 09/08/2024 with an expiration of 09/08/2033. The filing states the reporting person received no consideration for the cancellation and reports 0 derivative securities owned after the transaction. The Form 4 was signed by an attorney-in-fact on 08/13/2025.

Positive

  • None.

Negative

  • None.

Insights

TL;DR: Option for 3,750 shares cancelled by mutual agreement; reporting person holds zero derivative securities after the transaction.

The Form 4 documents a clear disposition: an option adjusted for a 1-for-20 reverse split and then cancelled on 08/11/2025. The filing explicitly states the reporting person received no consideration and lists zero derivative securities held following the cancellation. From a securities-disclosure perspective this is a straightforward reporting of an insider-derived change in beneficial ownership; the document provides the exercise price ($40), exercisable date (09/08/2024) and expiration (09/08/2033).

TL;DR: Director Christopher Capelli disclosed cancellation of an option for 3,750 shares; cancellation was mutual and uncompensated.

The disclosure adheres to Section 16 reporting requirements by detailing the cancelled derivative security, including the adjusted exercise price after a reverse split and the fact that no consideration was paid. The filing was executed by an attorney-in-fact and reports the reporting person holds no remaining derivative interest from this grant. The item is a corporate-records action requiring disclosure rather than an operational or financial statement about company performance.

Insider Capelli Christopher
Role Director
Type Security Shares Price Value
Disposition Option (Right to buy) 3,750 $0.00 $0.00
Holdings After Transaction: Option (Right to buy) — 0 shares (Direct)
Footnotes (1)
  1. F1. Option represents a revised share amount and exercise price based on a 1-for-20 reverse stock split from October 25, 2024. The option was cancelled by mutual agreement of the reporting person and the Company. The reporting person received no consideration for the cancellation.

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FAQ

What did Christopher Capelli report on the AMIX Form 4?
The filing reports the cancellation of an option covering 3,750 underlying shares, cancelled on 08/11/2025 by mutual agreement.

How many derivative securities does Christopher Capelli hold after the reported transaction?
The Form 4 states the reporting person holds 0 derivative securities following the cancellation.

What was the exercise price and why was it adjusted?
The option showed an adjusted exercise price of $40, reflecting a 1-for-20 reverse stock split referenced in the filing.

What were the option exercisable and expiration dates listed on the Form 4?
The option was listed as exercisable on 09/08/2024 with an expiration date of 09/08/2033.

Did the reporting person receive any payment for the cancellation?
No. The filing explicitly states the reporting person received no consideration for the cancellation.

Who signed the Form 4 and when was it signed?
The Form 4 was signed by Trent Smith, Attorney-in-Fact for Christopher Capelli on 08/13/2025.
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
OMB APPROVAL
OMB Number: 3235-0287
Estimated average burden
hours per response: 0.5
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan for the purchase or sale of equity securities of the issuer that is intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10.
1. Name and Address of Reporting Person*
Capelli Christopher
(Last) (First) (Middle)
21 WATERWAY AVENUE
SUITE 300
(Street)
THE WOODLANDS TX 77380
(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
Autonomix Medical, Inc. [ AMIX ] 		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)
08/11/2025
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
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
Option (Right to buy) $40(1) 08/11/2025 D 3,750(1) 09/08/2024 09/08/2033 Common Stock 3,750 (1) 0 D
Explanation of Responses:
1. Option represents a revised share amount and exercise price based on a 1-for-20 reverse stock split from October 25, 2024. The option was cancelled by mutual agreement of the reporting person and the Company. The reporting person received no consideration for the cancellation.
/s/ Trent Smith, Attorney-in-Fact for Christopher Capelli 08/13/2025
** 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).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.

Source: View Original Filing on SEC EDGAR