0001127602-23-022151.txt : 20230807 0001127602-23-022151.hdr.sgml : 20230807 20230807172237 ACCESSION NUMBER: 0001127602-23-022151 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230803 FILED AS OF DATE: 20230807 DATE AS OF CHANGE: 20230807 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Newhouse Phyllis W. CENTRAL INDEX KEY: 0001847751 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40209 FILM NUMBER: 231148582 MAIL ADDRESS: STREET 1: 125 TOWNPARK DRIVE, SUITE 300 CITY: KENNESAW STATE: GA ZIP: 30144 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Heliogen, Inc. CENTRAL INDEX KEY: 0001840292 STANDARD INDUSTRIAL CLASSIFICATION: ELECTRIC SERVICES [4911] IRS NUMBER: 854204953 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 130 W UNION ST. CITY: PASADENA STATE: CA ZIP: 91103 BUSINESS PHONE: 9709240446 MAIL ADDRESS: STREET 1: 130 W UNION ST. CITY: PASADENA STATE: CA ZIP: 91103 FORMER COMPANY: FORMER CONFORMED NAME: Athena Technology Acquisition Corp. DATE OF NAME CHANGE: 20210112 4 1 form4.xml PRIMARY DOCUMENT X0508 4 2023-08-03 0001840292 Heliogen, Inc. HLGN 0001847751 Newhouse Phyllis W. C/O HELIOGEN, INC. 130 WEST UNION ST PASADENA CA 91103 1 0 Common Stock 2023-08-03 4 A 0 75000 0 A 4266402 D Common Stock 246483 I See Footnote Consists of 75,000 restricted stock units ("RSUs") granted to the Reporting Person under the 2021 Equity Incentive Plan (the "Plan"), pursuant to the Amended and Restated Non-Employee Director Compensation Policy of the Issuer, vesting on the earlier of (i) August 3, 2024 and (ii) the day before the Issuer's next annual meeting of shareholders after the grant date, in each case, subject to the Reporting Person's continuous service as defined in the Plan through the vesting date. The RSUs are payable in an equivalent number of shares of common stock of the Issuer. Also includes 40,404 RSUs granted to the Reporting Person under the Plan vesting in three equal annual installments such that the RSUs are fully vested on December 31, 2024, subject to the Reporting Person's continuous service as defined in the Plan through each vesting date. The RSUs are payable in an equivalent number of shares of common stock of the Issuer. The reportable securities are held by a grantor retained annuity trust, the EVN 2022 GRAT fbo Ezekiel Newhouse, for which the Reporting Person serves as trustee. /s/ Alexander Gefter, Attorney in Fact 2023-08-07