Lucira Health, Inc. Form 4 (Sept. 15, 2022)

Summary

A Form 4 Statement of Changes in Beneficial Ownership for Lucira Health, Inc. [LHDX], filed for Erik T. Engelson, who is marked as a Director and as an officer with the title President and Chief Executive. Table I reports 20,000 shares of common stock acquired on 09/15/2022 under transaction code P at $1.82, after which 83,282 shares are owned directly. The form also lists 46,400 shares owned indirectly through the Elizabeth North Engelson Trust, for which Mr. Engelson serves as trustee, and 191,705 shares in the name of Epic Pacific, LLC, of which Mr. Engelson is a Member. Mr. Engelson disclaims beneficial ownership of these securities except to the extent of his pecuniary interest. Dan George signed as Attorney-in-Fact on 09/19/2022.

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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 * Engelson Erik T. (Last) (First) (Middle) C/O LUCIRA HEALTH INC. 1412 62ND ST (Street) EMERYVILLE CA 94608 (City) (State) (Zip) | Engelson Erik T. | (Last) | (First) | (Middle) | C/O LUCIRA HEALTH INC. | 1412 62ND ST | EMERYVILLE | CA | 94608 | (City) | (State) | (Zip) | 2. Issuer Name and Ticker or Trading Symbol Lucira Health, Inc. [ LHDX ] | 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 Chief Executive | X | Director | 10% Owner | X | Officer (give title below) | Other (specify below) | President and Chief Executive
3. Date of Earliest Transaction
 (Month/Day/Year) 09/15/2022
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 | 09/15/2022 | P | 20,000 | A | $ 1.82 | 83,282 | D
Common Stock | 46,400 | I | See Footnotes (1)
Common Stock | 191,705 | I | See Footnotes (2)
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 shares are held by the Elizabeth North Engelson Trust, dated January 17, 2001, for which Mr. Engelson serves as trustee.
2. The shares are held by Epic Pacific, LLC, of which Mr. Engelson is a Member. Mr. Engelson disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein.
Remarks:
/s/ Dan George, Attorney-in-Fact for Erik T. Engelson | 09/19/2022
** 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_LHDX_4_filed2022-09-19_0001209191-22-050460.xml

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Our copy

SEC_LHDX_4_filed2022-09-19_0001209191-22-050460.xml

Original

www.sec.gov