HeartBeam, Inc. — Director's Dealing 2021

Nov 13, 2021

SEC Form 3 — Initial Statement of Beneficial Ownership

Issuer: HeartBeam, Inc. (BEAT)
CIK: 0001779372
Period of Report: 2021-11-10

Reporting Person: BROUNSTEIN RICHARD D (Chief Financial Officer)

Holdings (Non-Derivative)

Security	Shares	Ownership
Common Stock	62878	Direct

Holdings (Derivative)

Security	Exercise Price	Expiration	Underlying	Shares	Ownership
Convertible Promissory Note	$		Common Stock (19465)		Indirect
Convertible Promissory Note	$		Common Stock (9732)		Indirect
Stock option (right to buy)	$0.0003	2029-01-10	Common Stock (9849)		Direct
Common Stock warrant (right to buy)	$2.75	2023-02-11	Common Stock (1455)		Direct

Footnotes

F1: Represents $81,753.00 of outstanding principal and interest calculated through November 10, 2021. The note will convert into 19,465 shares of Common Stock upon the closing of the Issuer's initial public offering of Common Stock (the "IPO").

F2: Represents $40,874.40 of outstanding principal and interest calculated through November 10, 2021. The note will convert into 9,732 shares of Common Stock upon the closing of the IPO.

F3: The Convertible Promissory Note is held by the R and S Brounstein Living Trust, of which the Reporting Person is a trustee.

F4: The Convertible Promissory Note is held by CTRLCFO, LLC, of which the Reporting Person is the Manager.

F5: One thirteeth of the shares subject to the option vest on each one-month anniversary beginning December 2, 2021 and each one-month anniversary thereafter, subject to the Reporting Person continuing as a service provider through each such date.

F6: All of the shares subject to the warrant are fully vested and exercisable as of the date hereof.