SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person*
Cypress Family Trust dated June 10, 2022

(Last) (First) (Middle)
1345 AVENUE OF THE AMERICAS
32ND FLOOR

(Street)
NEW YORK NY 10105

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
04/01/2023
3. Issuer Name and Ticker or Trading Symbol
Bluerock Homes Trust, Inc. [ BHM ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director X 10% Owner
Officer (give title below) Other (specify below)
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
OP Units (1) (1) Class A Common Stock 632,929 (1) I See Footnote(1)
OP Units (2) (2) Class A Common Stock 1,395,853 (2) I See Footnote(2)
Explanation of Responses:
1. Represents units of limited partnership interest ("OP Units") in Bluerock Residential Holdings, LP (the "Operating Partnership"), of which the Issuer is the general partner, transferred to the Reporting Person by its settlor, who is neither a trustee nor a beneficiary of the Reporting Person, for no consideration, and subsequently transferred by the Reporting Person to a limited liability company in which the Reporting Person owns a direct majority interest. After a one year holding period (including any period during which the underlying long-term incentive plan units ("LTIP Units") in the Operating Partnership were held), the OP Units may be redeemed for cash or, at the option of the Issuer, settled in shares of the Issuer's Class A common stock on a one-for-one basis, subject to certain adjustments and the terms and conditions of the Second Amended and Restated Agreement of Limited Partnership of the Operating Partnership, as amended (the "Partnership Agreement").
2. Represents OP Units transferred to a limited liability company in which the Reporting Person owns a direct majority interest by a separate irrevocable trust of which beneficiaries of the Reporting Person, or their immediate family members, are also the beneficiaries and of which the Reporting Person is neither a trustee nor a beneficiary.
Remarks:
The Reporting Person is an irrevocable trust formed in 2022 for estate planning purposes by its settlor, who is neither a trustee nor a beneficiary of the Reporting Person, in accordance with the laws of the State of Delaware. This Form 3 reports securities indirectly held by the Reporting Person through its ownership of membership interests in a limited liability company in which the Reporting Person owns a direct majority interest. Exhibit 24 - Power of Attorney
/s/ Christopher J. Vohs, Attorney-in-fact 11/13/2023
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.