Initial Statement of Beneficial Ownership (3)
September 03 2021 - 7:04PM
Edgar (US Regulatory)
FORM 3
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0104
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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
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TOCIO MARY ANN |
2. Date of Event Requiring Statement (MM/DD/YYYY)
9/1/2021
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3. Issuer Name and Ticker or Trading Symbol
1Life Healthcare Inc [ONEM]
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(Last)
(First)
(Middle)
C/O 1LIFE HEALTHCARE, INC., ONE EMBARCADERO CENTER, SUITE 1900 |
4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
__X__ Director _____ 10% Owner _____ Officer (give title below) _____ Other (specify below)
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(Street)
SAN FRANCISCO, CA 94111
(City)
(State)
(Zip)
| 5. If Amendment, Date Original Filed(MM/DD/YYYY)
| 6. Individual or Joint/Group Filing(Check Applicable Line)
_X_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Beneficially Owned
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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) |
Common Stock (1) | 38920.00 | D | |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security (Instr. 4) | 2. Date Exercisable and Expiration Date (MM/DD/YYYY) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form of Derivative Security: 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 |
Stock Options (Right to buy) | (1)(2) | 11/26/2030 | Common Stock | 12214.00 | $3.63 | D | |
Explanation of Responses: |
(1) | The shares of common stock and stock options were issued or granted, as applicable, to the reporting person in exchange for shares of common stock and stock options of Iora Health, Inc. ("Iora"), respectively, upon the effective time of the merger between the issuer and Iora (the "Merger") and pursuant to an exchange ratio set forth in the related merger agreement, dated June 6, 2021. Such issuance and grant were made pursuant to the exemption set forth in Rule 16b-3. |
(2) | The shares subject to the option fully vested immediately as of the effective date of the Merger. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
TOCIO MARY ANN C/O 1LIFE HEALTHCARE, INC. ONE EMBARCADERO CENTER, SUITE 1900 SAN FRANCISCO, CA 94111 | X |
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Signatures
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/s/ Ivy Tseng, Attorney-in-Fact for Mary Ann Tocio | | 9/3/2021 |
**Signature of Reporting Person | Date |
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