0001140361-21-032809.txt : 20210928
0001140361-21-032809.hdr.sgml : 20210928
20210928171738
ACCESSION NUMBER: 0001140361-21-032809
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210924
FILED AS OF DATE: 20210928
DATE AS OF CHANGE: 20210928
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Achar Christopher K
CENTRAL INDEX KEY: 0001868312
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-40824
FILM NUMBER: 211288278
MAIL ADDRESS:
STREET 1: C/O CUE HEALTH INC.
STREET 2: 4980 CARROLL CANYON RD. SUITE 100
CITY: SAN DIEGO
STATE: CA
ZIP: 92121
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Cue Health Inc.
CENTRAL INDEX KEY: 0001628945
STANDARD INDUSTRIAL CLASSIFICATION: LABORATORY ANALYTICAL INSTRUMENTS [3826]
IRS NUMBER: 000000000
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 4980 CARROLL CANYON ROAD
STREET 2: SUITE 100
CITY: SAN DIEGO
STATE: CA
ZIP: 92121
BUSINESS PHONE: (858) 412-8151
MAIL ADDRESS:
STREET 1: 4980 CARROLL CANYON ROAD
STREET 2: SUITE 100
CITY: SAN DIEGO
STATE: CA
ZIP: 92121
FORMER COMPANY:
FORMER CONFORMED NAME: Cue Inc.
DATE OF NAME CHANGE: 20141223
FORMER COMPANY:
FORMER CONFORMED NAME: Cue, Inc.
DATE OF NAME CHANGE: 20141222
4
1
form4.xml
FORM 4
X0306
4
2021-09-24
0001628945
Cue Health Inc.
HLTH
0001868312
Achar Christopher K
C/O CUE HEALTH INC.
4980 CARROLL CANYON RD. SUITE 100
SAN DIEGO
CA
92121
true
Common Stock
2021-09-24
4
A
0
1388246
0
A
1388246
D
Common Stock
2021-09-28
4
C
0
69710
A
1457956
D
Common Stock
1520000
I
See Footnote
Series B Preferred Stock
2021-09-28
4
C
0
69710
D
Common Stock
69710
0
D
Grant of restricted stock units ("RSUs") under the Issuer's 2021 Stock Incentive Plan. Each RSU represents a contingent right to receive one share of the Issuer's common stock. Subject to the reporting person's continued service with the Issuer, the RSUs will vest as to 25% of the initial grant on each anniversary of the grant date until the grant is fully vested on the fourth anniversary of the grant date.
Includes 1,388,246 unvested RSUs.
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.
The securities are directly held by Hlth Wrk LLC. Chris Achar is the sole manager of Hlth Wrk LLC and may be deemed to have voting and investment power with respect to the shares held by Hlth Wrk LLC and as a result may be deemed to have beneficial ownership of such shares.
/s/ Erica Palsis, Attorney-in-Fact for Chris Achar
2021-09-28