0001779372-24-000015.txt : 20240620
0001779372-24-000015.hdr.sgml : 20240620
20240620165041
ACCESSION NUMBER: 0001779372-24-000015
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20240612
FILED AS OF DATE: 20240620
DATE AS OF CHANGE: 20240620
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Elfrink Willem
CENTRAL INDEX KEY: 0001893194
ORGANIZATION NAME:
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-41060
FILM NUMBER: 241057187
MAIL ADDRESS:
STREET 1: 2118 WALSH AVE
STREET 2: SUITE 210
CITY: SANTA CLARA
STATE: CA
ZIP: 95050
FORMER NAME:
FORMER CONFORMED NAME: Elfrink Willhem
DATE OF NAME CHANGE: 20211110
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: HeartBeam, Inc.
CENTRAL INDEX KEY: 0001779372
STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841]
ORGANIZATION NAME: 08 Industrial Applications and Services
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
4
1
wk-form4_1718916634.xml
FORM 4
X0508
4
2024-06-12
0
0001779372
HeartBeam, Inc.
BEAT
0001893194
Elfrink Willem
2118 WALSH AVE, SUITE 210
SANTA CLARA
CA
95050
1
0
0
0
0
Common Stock
2024-06-12
4
A
0
33185
0
A
317982
D
Common Stock
106825
I
See Footnote
Common Stock (right to buy)
2.50
2031-06-15
Common Stock
43636
43636
D
Warrant (right to buy)
6
2021-12-21
2026-11-11
Common Stock
10000
10000
D
Warrant (right to buy)
6
2022-06-16
2026-11-11
Common Stock
50000
50000
D
These securities are restricted stock units (RSUs). Each RSU represents a contingent right to receive one share of Common Stock of the Issuer. 100% of the RSUs shall vest on the earlier of June 12, 2025, or the date of the Issuer's 2025 annual meeting of stockholders, subject to the Reporting Person continuing to be an Outside Director (as defined in the Issuer's 2022 Equity Inventive Plan) through the applicable vesting date.
These shares are held by the Elfrink Living Trust, of which the Reporting Person is the trustee.
One forty-eighth of the shares subject to the option vest on July 15, 2021 and each one-month anniversary thereafter, subject to the Reporting Person continuing as a service provider through each such date.
/s/ Willem Elfrink
2024-06-20