Cue Health Inc. Form 4 — Khattak Ayub K (March 2, 2023)

Summary

A Form 4 filed with the Securities and Exchange Commission for Ayub Khattak, a director of Cue Health Inc. with the officer title President and CEO. Table II reports a stock option for 808,511 shares granted on 03/02/2023 under the 2021 Stock Incentive Plan, with an exercise price of $2.08 and an expiration date of 03/02/2033, becoming exercisable in one-sixteenth portions each Quarterly Vesting Date from June 6, 2023. Table I shows 10,519 shares withheld at $2.11 on 03/06/2023 for the reporting person's tax liability on vesting restricted stock units, leaving 11,989,476 shares owned directly, including 985,615 unvested units. Erica Palsis signed as Attorney-in-Fact for Ayub Khattak on 03/06/2023.

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Full text

SEC Form 4

FORM 4 | UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 | OMB APPROVAL OMB Number: 3235-0287 Estimated average burden hours per response: 0.5 | OMB APPROVAL | OMB Number: 3235-0287 Estimated average burden hours per response: 0.5 | OMB Number: | 3235-0287 | Estimated average burden | hours per response: | 0.5
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person * Khattak Ayub K (Last) (First) (Middle) C/O CUE HEALTH INC. 4980 CARROLL CANYON RD. SUITE 100 (Street) SAN DIEGO CA 92121 (City) (State) (Zip) | Khattak Ayub K | (Last) | (First) | (Middle) | C/O CUE HEALTH INC. | 4980 CARROLL CANYON RD. SUITE 100 | SAN DIEGO | CA | 92121 | (City) | (State) | (Zip) | 2. Issuer Name and Ticker or Trading Symbol Cue Health Inc. [ HLTH ] | 5. Relationship of Reporting Person(s) to Issuer (Check all applicable) X Director 10% Owner X Officer (give title below) Other (specify below) President and CEO | X | Director | 10% Owner | X | Officer (give title below) | Other (specify below) | President and CEO
3. Date of Earliest Transaction
 (Month/Day/Year) 03/02/2023
4. 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 | X | Form filed by One Reporting Person | Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr.
 3) | 2. Transaction Date
 (Month/Day/Year) | 2A. Deemed Execution Date, if any
 (Month/Day/Year) | 3. Transaction Code (Instr.
 8) | 4. Securities Acquired (A) or Disposed Of (D) (Instr.
 3, 4 and 5) | 5.
 Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr.
 3 and 4) | 6. Ownership Form: Direct (D) or Indirect (I) (Instr.
 4) | 7. Nature of Indirect Beneficial Ownership (Instr.
 4)
Code | V | Amount | (A) or (D) | Price
Common Stock | 03/06/2023 | F | 10,519 (1) | D | $ 2.11 | 11,989,476 (2) | D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr.
 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date
 (Month/Day/Year) | 3A. Deemed Execution Date, if any
 (Month/Day/Year) | 4. Transaction Code (Instr.
 8) | 5.
 Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr.
 3, 4 and 5) | 6. Date Exercisable and Expiration Date
 (Month/Day/Year) | 7. Title and Amount of Securities Underlying Derivative Security (Instr.
 3 and 4) | 8. Price of Derivative Security (Instr.
 5) | 9.
 Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr.
 4) | 10. Ownership Form: Direct (D) or Indirect (I) (Instr.
 4) | 11. Nature of Indirect Beneficial Ownership (Instr.
 4)
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares
Stock Option (right to buy) | $ 2.08 | 03/02/2023 | A | 808,511 | (3) | 03/02/2033 | Common Stock | 808,511 | $ 0 | 808,511 | D
Explanation of Responses:
1. The reported shares were withheld to satisfy the reporting person's tax liability in connection with the vesting of restricted stock units ("RSUs").
2. Includes 985,615 unvested RSUs.
3. Stock option granted under the Issuer's 2021 Stock Incentive Plan and becomes exercisable on the first Quarterly Vesting Date that is on or after June 6, 2023 and as to one-sixteenth (1/16th) of the stock options on each Quarterly Vesting Date thereafter, subject to the reporting person providing continuous service through such date. "Quarterly Vesting Date" is the first trading day on or after each of March 5, June 5, September 5 and December 5.
Remarks:
Exhibit 24 - Power of Attorney
/s/ Erica Palsis, Attorney-in-Fact for Ayub Khattak | 03/06/2023
** 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
 4

 (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.

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SEC_CUE_4_filed2023-03-06_0001628945-23-000046.xml

Original

www.sec.gov