0001213900-23-010890.txt : 20230213
0001213900-23-010890.hdr.sgml : 20230213
20230213174246
ACCESSION NUMBER: 0001213900-23-010890
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20230201
FILED AS OF DATE: 20230213
DATE AS OF CHANGE: 20230213
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: CHASE DONALD R
CENTRAL INDEX KEY: 0001247473
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-41031
FILM NUMBER: 23620369
MAIL ADDRESS:
STREET 1: 39 TIMBER RIDGE RD.
CITY: WEST SPRINGFIELD
STATE: MA
ZIP: 01089
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Bluejay Diagnostics, Inc.
CENTRAL INDEX KEY: 0001704287
STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841]
IRS NUMBER: 473552922
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 360 MASSACHUSETTS AVENUE, SUITE 203
CITY: ACTON
STATE: MA
ZIP: 01720
BUSINESS PHONE: (978) 631-0152
MAIL ADDRESS:
STREET 1: 360 MASSACHUSETTS AVENUE, SUITE 203
CITY: ACTON
STATE: MA
ZIP: 01720
4
1
ownership.xml
X0306
4
2023-02-01
0
0001704287
Bluejay Diagnostics, Inc.
BJDX
0001247473
CHASE DONALD R
C/O BLUEJAY DIAGNOSTICS, INC, 360
MASSACHUSETTS AVENUE, SUITE 203
ACTON,
MA
01720
1
0
0
0
Common Stock
2023-02-01
4
A
0
27500
0.44
A
792852
D
(1) These shares of restricted stock vest at 100% on the first anniversary of the grant date.
/s/ Donald R Chase
2023-02-13