# EDGAR Filing Document

**Accession Number:** 0001965805
**File Stem:** 0001213900-23-012241
**Filing Date:** 2023-2
**Character Count:** 6871
**Document Hash:** 85d7d72e2ae3e1afc454b590eaa4b35b
**Contains OCR:** False
**Source Format:** 

## Filing Content

## Filing Summary
**0001213900-23-012241.hdr.sgml**: 20230215

**ACCESSION NUMBER**: 0001213900-23-012241

**CONFORMED SUBMISSION TYPE**: 3

**PUBLIC DOCUMENT COUNT**: 1

**CONFORMED PERIOD OF REPORT**: 20230214

**FILED AS OF DATE**: 20230215

**DATE AS OF CHANGE**: 20230215

**REPORTING-OWNER**: 

**OWNER DATA:**
- **COMPANY CONFORMED NAME:** Kuzemchik Vladislav
- **CENTRAL INDEX KEY:** 0001965805

**FILING VALUES:**
- **FORM TYPE:** 3
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 001-41626
- **FILM NUMBER:** 23636888

**MAIL ADDRESS:**
- **STREET 1:** 180 MAIDEN LANE
- **STREET 2:** 11TH FLOOR
- **CITY:** NEW YORK
- **STATE:** NY
- **ZIP:** 10005
**ISSUER**: 

**COMPANY DATA:**
- **COMPANY CONFORMED NAME:** NYIAX, INC.
- **CENTRAL INDEX KEY:** 0001679379
- **STANDARD INDUSTRIAL CLASSIFICATION:** SERVICES-COMPUTER PROCESSING & DATA PREPARATION [7374]
- **IRS NUMBER:** 460547534
- **STATE OF INCORPORATION:** DE
- **FISCAL YEAR END:** 1231

**BUSINESS ADDRESS:**
- **STREET 1:** 244 5TH AVENUE
- **STREET 2:** SUITE 2669
- **CITY:** NEW YORK
- **STATE:** NY
- **ZIP:** 10001
- **BUSINESS PHONE:** 4156027855

**MAIL ADDRESS:**
- **STREET 1:** 244 5TH AVENUE
- **STREET 2:** SUITE 2669
- **CITY:** NEW YORK
- **STATE:** NY
- **ZIP:** 10001

### UNITED STATES SECURITIES AND EXCHANGE COMMISSION
**Washington, D.C. 20549**

## FORM 3

### INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

[ ] Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).

---

| | | |
|:---|:---|:---|
| **1. Name and Address of Reporting Person**<sup>*</sup><br>Kuzemchik Vladislav<br><sub>(Last) (First) (Middle)</sub><br>C/O NYIAX, INC.<br>180 MAIDEN LANE, 11TH FLOOR<br><sub>(Street)</sub><br>NEW YORK, NY 10005<br><sub>(City) (State) (Zip)</sub> | **3. Issuer Name and Ticker or Trading Symbol**<br>NYIAX, INC. [ NYX ] | **5. If Amendment, Date of Original Filed (Month/Day/Year)**<br>  |
| **2. Date of Event Requiring Statement (Month/Day/Year)**<br>2023-02-14 | **4. Relationship of Reporting Person(s) to Issuer**<br>(Check all applicable)<br>[ ] Director   [ ] 10% Owner<br>[X] Officer (give title below)   [ ] Other (specify below)<br>_Chief Architect of Technology_ | **6. Individual or Joint/Group Filing (Check Applicable Line)**<br>[X] Form filed by One Reporting Person<br>[ ] 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 | 4. Nature of Indirect Beneficial Ownership |

---

## Table II - Derivative Securities Beneficially Owned

---

|  |  |  |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- |
| 1. Title of Derivative Security | 2. Date Exercisable and Expiration Date (Month/Day/Year) | 2. Date Exercisable and Expiration Date (Month/Day/Year) | 3. Title and Amount of Underlying Securities | 3. Title and Amount of Underlying Securities | 4. Conversion or Exercise Price | 5. Ownership Form | 6. Nature of Indirect Beneficial Ownership |
| 1. Title of Derivative Security | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | 4. Conversion or Exercise Price | 5. Ownership Form | 6. Nature of Indirect Beneficial Ownership |
| Stock Options<sup>(1)</sup> | <sup>(2)</sup> | 2028-06-18 | Common Stock | 25000 | $3.30 | D |  |
| Stock Options<sup>(3)</sup> | <sup>(2)</sup> | 2030-04-01 | Common Stock | 5000 | $3.30 | D |  |
| Stock Options<sup>(4)</sup> | <sup>(2)</sup> | 2030-09-28 | Common Stock | 20000 | $3.30 | D |  |
| Stock Options<sup>(5)</sup> | <sup>(2)</sup> | 2030-09-28 | Common Stock | 5000 | $4.30 | D |  |
| Stock Options<sup>(6)</sup> | <sup>(7)</sup> | 2032-11-01 | Common Stock | 25000 | $5.50 | D |  |
| Stock Options<sup>(8)</sup> | <sup>(9)</sup> | 2032-04-01 | Common Stock | 1500 | $5.50 | D |  |

---

### Footnotes:

(1) On June 18, 2018, the Reporting Person was issued stock options to purchase 25,000 shares of common stock of the Issuer with 8,334 options vesting immediately as of October 18, 2018 and 16,666 options vesting in 1/24 equal increments per month from October 18, 2018.

(2) These options are fully vested and exercisable.

(3) On April 1, 2020, the Reporting Person was issued stock options to purchase 5,000 shares of common stock of the Issuer with all 5,000 options vesting as of June 1, 2020.

(4) On October 1, 2020, the Reporting Person was issued stock options to purchase 20,000 shares of common stock of the Issuer with 1,666 options vesting immediately as of October 1, 2020 and 18,333 options vesting in 1,666 options per month increments thereafter.

(5) On October 1, 2020, the Reporting Person was issued stock options to purchase 5,000 shares of common stock of the Issuer with 416.66 options vesting immediately as of October 1, 2020 and approximately 4,583 options vesting in 416.66 options per month increments thereafter.

(6) On April 27, 2022, the Reporting Person was issued stock options to purchase 25,000 shares of common stock of the Issuer vesting (at a rate of 1/48 of the total award of 25,000 options) over a four-year period with twelve months vesting on November 11, 2022 and vesting continuing monthly thereafter, until the stock option award is fully vested.

(7) The stock options vest (at a rate of 1/48 of the total award of 25,000 options) over a four-year period with twelve months vesting on November 11, 2022 and vesting continuing monthly thereafter, until fully vested.

(8) On April 27, 2022, the Reporting Person was issued stock options to purchase 1,500 shares of common stock of the Issuer vesting (at a rate of 1/48 of the total award of 1,500 options) over a four-year period with twelve months vesting on January 1, 2023 and vesting continuing monthly thereafter, until the stock option award is fully vested.

(9) The stock options vest (at a rate of 1/48 of the total award of 1,500 options) over a four-year period with twelve months vesting on January 1, 2023 and vesting continuing monthly thereafter, until fully vested.

**Signature:** /s/ Vladislav Kuzemchik  
**Date:** 2023-02-15

### Remarks:

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.**