0001140361-21-032354.txt : 20210923 0001140361-21-032354.hdr.sgml : 20210923 20210923210609 ACCESSION NUMBER: 0001140361-21-032354 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210923 FILED AS OF DATE: 20210923 DATE AS OF CHANGE: 20210923 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Sherpa Ventures Fund, LP CENTRAL INDEX KEY: 0001580437 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40824 FILM NUMBER: 211273802 BUSINESS ADDRESS: STREET 1: 555 MISSION STREET, SUITE 1850 CITY: SAN FRANCISCO STATE: CA ZIP: 94105-0937 BUSINESS PHONE: (415) 655 9887 MAIL ADDRESS: STREET 1: 555 MISSION STREET, SUITE 1850 CITY: SAN FRANCISCO STATE: CA ZIP: 94105-0937 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Sherpa Ventures Fund GP, LLC CENTRAL INDEX KEY: 0001580438 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40824 FILM NUMBER: 211273800 BUSINESS ADDRESS: STREET 1: 555 MISSION STREET, SUITE 1850 CITY: SAN FRANCISCO STATE: CA ZIP: 94105-0937 BUSINESS PHONE: (415) 655 9887 MAIL ADDRESS: STREET 1: 555 MISSION STREET, SUITE 1850 CITY: SAN FRANCISCO STATE: CA ZIP: 94105-0937 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Stanford Scott CENTRAL INDEX KEY: 0001866544 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40824 FILM NUMBER: 211273798 MAIL ADDRESS: STREET 1: C/O PERSONALIZED BEAUTY DISCOVERY, INC. STREET 2: 201 BALDWIN AVENUE CITY: SAN MATEO STATE: CA ZIP: 94401 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SherpaVentures Fund II, LP CENTRAL INDEX KEY: 0001640276 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40824 FILM NUMBER: 211273801 BUSINESS ADDRESS: STREET 1: 800 MARKET STREET, SUITE 800 CITY: SAN FRANCISCO STATE: CA ZIP: 94102 BUSINESS PHONE: 415 805 8500 MAIL ADDRESS: STREET 1: 800 MARKET STREET, SUITE 800 CITY: SAN FRANCISCO STATE: CA ZIP: 94102 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SherpaVentures Fund II GP, LLC CENTRAL INDEX KEY: 0001640277 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40824 FILM NUMBER: 211273799 BUSINESS ADDRESS: STREET 1: 800 MARKET STREET, SUITE 800 CITY: SAN FRANCISCO STATE: CA ZIP: 94102 BUSINESS PHONE: 415 805 8500 MAIL ADDRESS: STREET 1: 800 MARKET STREET, SUITE 800 CITY: SAN FRANCISCO STATE: CA ZIP: 94102 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 3 1 form3.xml FORM 3 X0206 3 2021-09-23 0 0001628945 Cue Health Inc. HLTH 0001580437 Sherpa Ventures Fund, LP 800 MARKET STREET, 8TH FLOOR SAN FRANCISCO CA 94102 true 0001640276 SherpaVentures Fund II, LP 800 MARKET STREET, 8TH FLOOR SAN FRANCISCO CA 94102 true 0001580438 Sherpa Ventures Fund GP, LLC 800 MARKET STREET, 8TH FLOOR SAN FRANCISCO CA 94102 true 0001640277 SherpaVentures Fund II GP, LLC 800 MARKET STREET, 8TH FLOOR SAN FRANCISCO CA 94102 true 0001866544 Stanford Scott 800 MARKET STREET, 8TH FLOOR SAN FRANCISCO CA 92102 true true Common Stock 129354 D Common Stock 194031 D Series A Preferred Stock Common Stock 5450898 D Series B Preferred Stock Common Stock 3076224 D Series B Preferred Stock Common Stock 3834088 D Series C-1 Preferred Stock Common Stock 1092329 D Series C-1 Preferred Stock Common Stock 1092329 D 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 each of ACME GP I and ACME GP II (as defined below) and may be deemed to have voting and investment power with respect to the shares held by ACME I and ACME II (as defined below) and as a result may be deemed to have beneficial ownership of such shares. Each of the reporting persons disclaims beneficial ownership of the shares reported herein except to the extent of his or its respective pecuniary interest therein. 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 each of ACME GP I and ACME GP II and may be deemed to have voting and investment power with respect to the shares held by ACME I and ACME II and as a result may be deemed to have beneficial ownership of such shares. Each of the reporting persons disclaims beneficial ownership of the shares reported herein except to the extent of his or its respective pecuniary interest therein. The Series A Preferred Stock automatically converts into the number of shares of Common Stock as shown in Column 3 of Table II without payment of further consideration at the holder's election or upon closing of the initial public offering of the Issuer's common stock. The shares have no expiration date. The Series B Preferred Stock automatically converts into the number of shares of Common Stock as shown in Column 3 of Table II without payment of further consideration at the holder's election or upon closing of the initial public offering of the Issuer's common stock. The shares have no expiration date. The Series C-1 Preferred Stock automatically converts into the number of shares of Common Stock as shown in Column 3 of Table II without payment of further consideration at the holder's election or upon closing of the initial public offering of the Issuer's common stock. The shares have no expiration date. SHERPA VENTURES FUND, LP By: Sherpa Ventures Fund GP, LLC, its general partner By: /s/ Scott Stanford, Manager 2021-09-23 SHERPA VENTURES FUND II, LP By: Sherpa Ventures Fund II GP, LLC, its general partner By: /s/ Scott Stanford, Manager 2021-09-23 SHERPA VENTURES FUND GP, LLC By: /s/ Scott Stanford, Manager 2021-09-23 SHERPA VENTURES FUND II GP, LLC By: /s/ Scott Stanford, Manager 2021-09-23 /s/ Scott Stanford 2021-09-23