Sherpa Ventures Fund, LP - Sep 28, 2021 Form 4 Insider Report for Cue Health Inc. (HLTH)

Role
10%+ Owner
Signature
SHERPA VENTURES FUND, LP By: Sherpa Ventures Fund GP, LLC, its general partner By: /s/ Scott Stanford, Manager
Stock symbol
HLTH
Transactions as of
Sep 28, 2021
Transactions value $
$4,752,550
Form type
4
Date filed
9/30/2021, 05:35 PM
Previous filing
Sep 23, 2021

Transactions Table

Type Sym Class Transaction Value $ Shares Change % Price $ Shares After Date Ownership Footnotes
transaction HLTH Common Stock +Conversion of derivative security +9,619,451 +7436.53% 9,748,805 Sep 28, 2021 See footnote. F1, F2, F3, F4
transaction HLTH Common Stock +Conversion of derivative security +4,926,417 +2538.98% 5,120,448 Sep 28, 2021 See footnote. F2, F3, F5
transaction HLTH Common Stock +Other $4,752,550 +371,293 +7.25% $12.80 5,491,741 Sep 28, 2021 See footnote. F5, F6

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
transaction HLTH Series A Preferred Stock -Conversion of derivative security $0 -5,450,898 -100% $0.00 0 Sep 28, 2021 Common Stock 5,450,898 See footnote. F1, F4
transaction HLTH Series B Preferred Stock -Conversion of derivative security $0 -3,076,224 -100% $0.00 0 Sep 28, 2021 Common Stock 3,076,224 See footnote. F2, F4
transaction HLTH Series C-1 Preferred Stock -Conversion of derivative security $0 -1,092,329 -100% $0.00 0 Sep 28, 2021 Common Stock 1,092,329 See footnote. F3, F4
transaction HLTH Series B Preferred Stock -Conversion of derivative security $0 -3,834,088 -100% $0.00 0 Sep 28, 2021 Common Stock 3,834,088 See footnote. F2, F5
transaction HLTH Series C-1 Preferred Stock -Conversion of derivative security $0 -1,092,329 -100% $0.00 0 Sep 28, 2021 Common Stock 1,092,329 See footnote. F3, F5

Explanation of Responses:

Id Content
F1 On September 28, 2021, the Series A Preferred Stock automatically converted into Common Stock on a one-to-one basis without payment of further consideration upon the closing of the initial public offering of the Issuer's common stock. The shares had no expiration date.
F2 On September 28, 2021, the Series B Preferred Stock automatically converted into Common Stock on a one-to-one basis without payment of further consideration upon the closing of the initial public offering of the Issuer's common stock. The shares had no expiration date.
F3 On September 28, 2021, the Series C-1 Preferred Stock automatically converted into Common Stock on a one-to-one basis without payment of further consideration upon the closing of the initial public offering of the Issuer's common stock. The shares had no expiration date.
F4 The shares are held directly by Sherpa Ventures Fund, LP ("ACME I"). Sherpa Ventures Fund GP, LLC ("ACME GP I") is the general partner of ACME I. Each of the reporting persons disclaims beneficial ownership of the shares reported herein except to the extent of its respective pecuniary interest therein.
F5 The shares are held directly by Sherpa Ventures Fund II, LP ("ACME II"). Sherpa Ventures Fund II GP, LLC ("ACME GP II") is the general partner of ACME II. Each of the reporting persons disclaims beneficial ownership of the shares reported herein except to the extent of its respective pecuniary interest therein.
F6 On September 28, 2021, outstanding principal and accrued interest underlying a convertible note automatically converted into Common Stock upon the closing of the initial public offering of the Issuer's common stock at a conversion price equal to 80% of the initial public offering price per share.