Company: QTIWW
Filing Date: 2025-01-16
Form Type: S-1
Source: 0001628280-25-001723
Chunk: 139

Company: QT IMAGING HOLDINGS, INC.
Filing Date: 2025-01-16
Form: S-1
Chunk 139
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 Stock that upon the completion of the Business Combination and the application of the Exchange Ratio was exchanged for such consideration as was provided for in the Business Combination Agreement, including that number of shares of the Company’s Common Stock as was equal in the aggregate to 100,000 shares of the Company’s Common Stock. Upon conversion of aforementioned Senior Secured Convertible Notes, the unamortized associated deemed debt discount was fully expensed.

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### PRO FORMA COMBINED STATEMENT OF OPERATIONS

#### FOR THE YEAR ENDED DECEMBER 31, 2023
<div align='center'>(unaudited)</div>

|                                                                |     | QT Imaging, Inc. 
 (Historical)     |            |     | GigCapital5, Inc. 
 (Historical)      |            |     | Pro Forma   
 Adjustments |             |     |     |     | Pro Forma    
 Statement of 
 Operations   |             |
|:---------------------------------------------------------------|:----|:-----------------|-----------:|:----|:------------------|-----------:|:----|:------------|------------:|:----|:----|:----|:-------------|------------:|
| Revenue                                                        |     | $                |     40,355 |     | $                 |          — |     | $           |           — |     |     |     | $            |      40,355 |
| Cost of revenue                                                |     |                  |    134,988 |     |                   |          — |     |             |           — |     |     |     |              |     134,988 |
| Gross profit                                                   |     |                  |    -94,633 |     |                   |          — |     |             |           — |     |     |     |              |     -94,633 |
| Operating Expenses:                                            |     |                  |            |     |                   |            |     |             |             |     |     |     |              |             |
| Research and development                                       |     |                  |  1,485,636 |     |                   |          — |     |             |    -105,255 |     | -P  |     |              |   1,380,381 |
| Selling, general, and administrative                           |     |                  |  3,427,690 |     |                   |  4,927,599 |     |             |    -604,139