0001213900-21-058857.txt : 20211112
0001213900-21-058857.hdr.sgml : 20211112
20211112201502
ACCESSION NUMBER: 0001213900-21-058857
CONFORMED SUBMISSION TYPE: 3
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20211110
FILED AS OF DATE: 20211112
DATE AS OF CHANGE: 20211112
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Hunt Jon Patrick
CENTRAL INDEX KEY: 0001893665
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-41060
FILM NUMBER: 211405743
MAIL ADDRESS:
STREET 1: 2118 WALSH AVE
STREET 2: SUITE 210
CITY: SANTA CLARA
STATE: CA
ZIP: 95050
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: HeartBeam, Inc.
CENTRAL INDEX KEY: 0001779372
STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841]
IRS NUMBER: 474881450
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 2118 WALSH AVE., SUITE 210
CITY: SANTA CLARA
STATE: CA
ZIP: 95050
BUSINESS PHONE: 408-899-4443
MAIL ADDRESS:
STREET 1: 2118 WALSH AVE., SUITE 210
CITY: SANTA CLARA
STATE: CA
ZIP: 95050
3
1
ownership.xml
OWNERSHIP DOCUMENT
X0206
3
2021-11-10
0
0001779372
HeartBeam, Inc.
BEAT
0001893665
Hunt Jon Patrick
2118 WALSH AVE, SUITE 210
SANTA CLARA
CA
95050
0
1
0
0
Chief Business Officer
Convertible Promissory Note
Common Stock
23976
I
See Footnote
Represents $100,699.20 of outstanding principal and interest calculated through November 10, 2021. The note will convert into 23,976 shares Common Stock upon the closing of the Issuer's initial public offering of Common Stock (the "IPO").
Convertible Promissory Note is held by the Jon P and Christine M Hunt.
/s/ Jon Hunt
2021-11-10