Scott Stanford - 28 Sep 2021 Form 4 Insider Report for Cue Health Inc.

Role
Director, 10%+ Owner
Signature
/s/ Erica Palsis, Attorney-in-Fact for Scott Stanford
Issuer symbol
N/A
Transactions as of
28 Sep 2021
Net transactions value
+$4,752,550
Form type
4
Filing time
30 Sep 2021, 17:39:35 UTC
Previous filing
23 Sep 2021
Next filing
12 Nov 2021
SEC
View on sec.gov

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 +7437% 9,748,805 28 Sep 2021 See Footnotes F1, F2, F3, F4
transaction HLTH Common Stock Conversion of derivative security +4,926,417 +2539% 5,120,448 28 Sep 2021 See Footnotes F2, F3, F5
transaction HLTH Common Stock Award $4,752,550 +371,293 +7.3% $12.80* 5,491,741 28 Sep 2021 See Footnotes 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% $0.000000* 0 28 Sep 2021 Common Stock 5,450,898 See Footnotes F1, F4
transaction HLTH Series B Preferred Stock Conversion of derivative security $0 -3,076,224 -100% $0.000000* 0 28 Sep 2021 Common Stock 3,076,224 See Footnotes F2, F4
transaction HLTH Series C-1 Preferred Stock Conversion of derivative security $0 -1,092,329 -100% $0.000000* 0 28 Sep 2021 Common Stock 1,092,329 See Footnotes F3, F4
transaction HLTH Series B Preferred Stock Conversion of derivative security $0 -3,834,088 -100% $0.000000* 0 28 Sep 2021 Common Stock 3,834,088 See Footnotes F2, F5
transaction HLTH Series C-1 Preferred Stock Conversion of derivative security $0 -1,092,329 -100% $0.000000* 0 28 Sep 2021 Common Stock 1,092,329 See Footnotes F3, F5
* An asterisk sign (*) next to the price indicates that the price is likely invalid.

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. Scott Stanford is the sole managing member of ACME GP I and may be deemed to have voting and investment power with respect to the shares held by ACME I and as a result may be deemed to have beneficial ownership of such shares. The reporting person disclaims beneficial ownership of the shares reported herein except to the extent of his 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. Scott Stanford is the sole managing member of ACME GP II and may be deemed to have voting and investment power with respect to the shares held by ACME II and as a result may be deemed to have beneficial ownership of such shares. The reporting person disclaims beneficial ownership of the shares reported herein except to the extent of his 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.