Form 4: Cue Health Inc. (HLTH), Khattak Ayub K, transaction 09/25/2023
Summary
A Form 4 filed with the Securities and Exchange Commission for Ayub Khattak, a director of Cue Health Inc. whose officer title is President and CEO. The issuer withheld 31,938 shares of common stock on 09/25/2023 at $0.45 to satisfy the reporting person's tax liability in connection with vesting restricted stock units. The reporting person's directly owned shares then totaled 11,897,285, including 750,172 unvested units. The form is signed by Erica Palsis, Attorney-in-Fact for Ayub Khattak, and dated 09/27/2023.
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Cite this document
“Form 4: Cue Health Inc. (HLTH), Khattak Ayub K, transaction 09/25/2023.”
Original at www.sec.gov. Archived at Pandemic Darlings, https://pandemicdarlings.com/source-documents/sec-cue-4-filed2023-09-27-0001628945-23-000166-c4049826f4/
, SHA-256 8638bc7f32c40fc5521404b8f444c591d744a86682a47ab790c9c95b263b2dbe.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).
Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan for the purchase or sale of equity securities of the issuer that is intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10.
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) 09/25/2023
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 | 09/25/2023 | F | 31,938 (1) | D | $ 0.45 | 11,897,285 (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
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 750,172 unvested RSUs.
Remarks:
/s/ Erica Palsis, Attorney-in-Fact for Ayub Khattak | 09/27/2023
** 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_filed2023-09-27_0001628945-23-000166.xml
- Size
- 15,658 bytes
- SHA-256
- 8638bc7f32c40fc5521404b8f444c591d744a86682a47ab790c9c95b263b2dbe
- Original
- www.sec.gov