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

Role
Chief Financial Officer
Signature
/s/ Richard Brounstein
Stock symbol
BEAT
Transactions as of
Nov 10, 2021
Transactions value $
$0
Form type
3
Date filed
11/12/2021, 07:12 PM
Next filing
Nov 15, 2021

Transactions Table

Type Sym Class Transaction Value $ Shares Change % * Price $ Shares After Date Ownership Footnotes
holding BEAT Common Stock 62.9K Nov 10, 2021 Direct

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 19.5K See Footnote F1, F3
holding BEAT Convertible Promissory Note Nov 10, 2021 Common Stock 9.73K See Footnote F2, F4
holding BEAT Stock option (right to buy) Nov 10, 2021 Common Stock 9.85K $0.00 Direct F5
holding BEAT Common Stock warrant (right to buy) Nov 10, 2021 Common Stock 1.46K $2.75 Direct F6
* An asterisk sign (*) next to the price indicates that the price is likely invalid.

Explanation of Responses:

Id Content
F1 Represents $81,753.00 of outstanding principal and interest calculated through November 10, 2021. The note will convert into 19,465 shares of Common Stock upon the closing of the Issuer's initial public offering of Common Stock (the "IPO").
F2 Represents $40,874.40 of outstanding principal and interest calculated through November 10, 2021. The note will convert into 9,732 shares of Common Stock upon the closing of the IPO.
F3 The Convertible Promissory Note is held by the R and S Brounstein Living Trust, of which the Reporting Person is a trustee.
F4 The Convertible Promissory Note is held by CTRLCFO, LLC, of which the Reporting Person is the Manager.
F5 One thirteeth of the shares subject to the option vest on each one-month anniversary beginning December 2, 2021 and each one-month anniversary thereafter, subject to the Reporting Person continuing as a service provider through each such date.
F6 All of the shares subject to the warrant are fully vested and exercisable as of the date hereof.