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HeartBeam, Inc. Director's Dealing 2021

Nov 12, 2021

34512_dirs_2021-11-12_ccaf755c-324c-44f8-a623-2cdae8f5614d.zip

Director's Dealing

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SEC Form 3 — Initial Statement of Beneficial Ownership

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

Reporting Person: Vajdic Branislav (Chief Executive Officer, 10% Owner)

Holdings (Non-Derivative)

Security Shares Ownership
Common Stock 794545 Direct

Holdings (Derivative)

Security Exercise Price Expiration Underlying Shares Ownership
Convertible Promissory Note $ Common Stock (115559) Direct
Common Stock warrant (right to buy) $2.75 2023-02-11 Common Stock (5818) Direct
Common Stock warrant (right to buy) $0.0003 2023-02-12 Common Stock (363636) Direct

Footnotes

F1: 32,727 shares are held in the name of his spouse, Marijana Rakic.

F2: Represents $485,347.80 of outstanding principal and interest calculated through November 10, 2021. The note will convert into 115,559 shares of Common Stock upon the closing of the Issuer's initial public offering of Common Stock (the "IPO").

F3: All of the shares subject to the warrant are fully vested and exercisable as of the date hereof.

F4: The shares subject to the warrant are exercisable upon the earliest to occur of several events, including the closing of the IPO and the Issuer having a market capitalization of at least $50,000,000 for five consecutive business days.