0001213900-22-014604.txt : 20220323 0001213900-22-014604.hdr.sgml : 20220323 20220323201644 ACCESSION NUMBER: 0001213900-22-014604 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220322 FILED AS OF DATE: 20220323 DATE AS OF CHANGE: 20220323 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Gemignani Gary G CENTRAL INDEX KEY: 0001512256 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-41031 FILM NUMBER: 22764412 MAIL ADDRESS: STREET 1: C/O IASO PHARMA INC. STREET 2: 12707 HIGH BLUFF DRIVE, SUITE 200 CITY: SAN DIEGO STATE: CA ZIP: 92130 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 2022-03-22 0 0001704287 Bluejay Diagnostics, Inc. BJDX 0001512256 Gemignani Gary G C/O BLUEJAY DIAGNOSTICS, INC 360 MASSACHUSETTS AVENUE, SUITE 203 ACTON MA 01720 1 0 0 0 Option to purchase common stock 1.26 2022-03-22 4 A 0 2500 A 2032-03-22 Common Stock 2500 27500 D The stock options set forth in this table vest on December 15, 2022, subject to the grantee's continued service to the Company on the vesting date. The stock options were issued in connection with the reporting person's Board of Director services to the Company. /s/ Gary Gemignani 2022-03-23