Cue Health Inc. Form 4 — Achar Christopher K (June 5, 2023)

Summary

A Form 4 filed with the Securities and Exchange Commission for Chris Achar, a director of Cue Health Inc. On 06/05/2023, 6,965 shares of common stock were withheld at $0.6 to satisfy the reporting person's tax liability on vesting restricted stock units, leaving 1,524,563 shares owned directly, including 1,216,972 unvested units. A second line lists 1,520,000 shares owned indirectly through Hlth Wrk LLC; the footnote says the reporting person is its sole manager and may be deemed to have voting and investment power over, and beneficial ownership of, those shares. The form is signed by Erica Palsis, Attorney-in-Fact for Chris Achar, and dated 06/07/2023.

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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 * Achar Christopher K (Last) (First) (Middle) C/O CUE HEALTH INC. 4980 CARROLL CANYON RD. SUITE 100 (Street) SAN DIEGO CA 92121 (City) (State) (Zip) | Achar Christopher 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 Officer (give title below) Other (specify below) | X | Director | 10% Owner | Officer (give title below) | Other (specify below)
3. Date of Earliest Transaction
 (Month/Day/Year) 06/05/2023
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
Rule 10b5-1(c) Transaction Indication Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan that is intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10. | Rule 10b5-1(c) Transaction Indication | Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan that is intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10.
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 | 06/05/2023 | F | 6,965 (1) | D | $ 0.6 | 1,524,563 (2) | D
Common Stock | 1,520,000 | I | See Footnote (3)
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
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 1,216,972 unvested RSUs.
3. The securities are directly held by Hlth Wrk LLC. The reporting person is the sole manager of Hlth Wrk LLC and may be deemed to have voting and investment power with respect to the shares held by Hlth Wrk LLC and as a result may be deemed to have beneficial ownership of such shares.
Remarks:
/s/ Erica Palsis, Attorney-in-Fact for Chris Achar | 06/07/2023
** 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.

File and source

File

SEC_CUE_4_filed2023-06-07_0001628945-23-000119.xml

Size

16,683 bytes

SHA-256

1cbad3613786512de21747b5a4eb4c7f70c8ba79f352e64d85472ddb1a2ba6dc

Our copy

SEC_CUE_4_filed2023-06-07_0001628945-23-000119.xml

Original

www.sec.gov