Initial Statement of Beneficial Ownership (3)
January 27 2023 - 04:06PM
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
Estimated average burden
hours per response... 0.5 |
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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 * ENO
Robert Paul |
2. Date of Event Requiring Statement
(MM/DD/YYYY)
1/18/2023
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3. Issuer Name and Ticker or Trading
Symbol HeartBeam, Inc. [BEAT] |
(Last)
(First)
(Middle)
2118 WALSH AVENUE, SUITE 210 |
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)_____
Director _____
10% Owner
___X___ Officer (give title
below) _____
Other (specify below)
President / |
(Street)
SANTA
CLARA, CA 95050
(City)
(State)
(Zip)
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5. If Amendment, Date Original
Filed(MM/DD/YYYY)
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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 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 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 option (right to buy) |
(1) |
1/11/2030 |
Common Stock |
36363.0 |
$0.28 |
D |
|
Stock option (right to buy) |
(2) |
2/11/2031 |
Common Stock |
9000.0 |
$4.25 |
D |
|
Stock option (right to buy) |
(3) |
1/18/2033 |
Common Stock |
240000.0 |
$4.465 |
D |
|
Explanation of
Responses: |
(1) |
28,788 shares subject to the
stock option are fully vested and exercisable. |
(2) |
2,631 shares subject to the
stock option are fully vested and exercisable. |
(3) |
Twenty-five percent (25%) of
the shares subject to the Stock Option shall vest on the one (1)
year anniversary of the Vesting Commencement Date (January 18,
2024), and one forty-eighth (1/48th) of the shares subject to the
Stock Option shall vest each month thereafter on the same day of
the month as the Vesting Commencement Date, subject to the Mr. Eno
continuing to be engaged with the company through each such date.
All shares subject to the Stock Option shall accelerate and vest in
full upon the company's termination of Mr. Eno's engagement with
the company following a Change in Control (as defined in the
company's 2022 equity incentive plan). |
Reporting
Owners
|
Reporting Owner Name / Address |
Relationships
|
Director |
10% Owner |
Officer |
Other |
ENO Robert Paul
2118 WALSH AVENUE, SUITE 210
SANTA CLARA, CA 95050 |
|
|
President |
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Signatures
|
/s/ Robert Paul Eno |
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1/27/2023 |
**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). |
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 control number. |
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