Richard Ferrari - Nov 10, 2021 Form 3 Insider Report for HeartBeam, Inc. (BEAT)

Role
Exec Chm of the BOD, Director
Signature
/s/ Richard Ferrari
Stock symbol
BEAT
Transactions as of
Nov 10, 2021
Transactions value $
$0
Form type
3
Date filed
11/12/2021, 07:13 PM
Previous filing
Jun 11, 2021
Next filing
Nov 15, 2021
SEC
View on sec.gov

Derivative Securities (e.g., puts, calls, warrants, options, convertible securities)

Type Sym Class Transaction Value $ Shares Change % * Price $ Shares After Date Underlying Class Amount Exercise Price Ownership Footnotes
holding BEAT Convertible Promissory Note Nov 10, 2021 Common Stock 65.7K See Footnote F1, F2
holding BEAT Stock option (right to buy) Nov 10, 2021 Common Stock 27.3K $0.28 Direct F3
holding BEAT Stock option (right to buy) Nov 10, 2021 Common Stock 182K $2.50 Direct F4
* An asterisk sign (*) next to the price indicates that the price is likely invalid.

Explanation of Responses:

Id Content
F1 Represents $275,742.60 of outstanding principal and interest calculated through November 10, 2021. The note will convert into 65,653 shares of Common Stock upon the closing of the Issuer's initial public offering of Common Stock (the "IPO").
F2 The Convertible Promissory Note is held by the Ferrari Living Trust, of which the Reporting Person is the trustee.
F3 Five forty-eighth of the shares vested on date of grant, May 12, 2020, one forty-eighth of the shares subject to the option vested June 11, 2020 and each one-month anniversary thereafter, subject to the Reporting Person continuing as a service provider through each such date.
F4 One forty-eighth of the shares subject to the option vest on July 15, 2021 and each one-month anniversary thereafter, subject to the Reporting Person continuing as a service provider through each such date.