Amended Statement of Changes in Beneficial Ownership (4/a)
April 29 2022 - 6:01PM
Edgar (US Regulatory)
FORM 4
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
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Sacks Ian |
2. Issuer Name and Ticker or Trading Symbol
HEALTHEQUITY, INC.
[
HQY
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director _____ 10% Owner _____ Officer (give title below) _____ Other (specify below)
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(Last)
(First)
(Middle)
C/O HEALTHEQUITY, INC., 15 W. SCENIC POINTE DR., STE. 100 |
3. Date of Earliest Transaction
(MM/DD/YYYY)
2/1/2022 |
(Street)
DRAPER, UT 84020
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
2/3/2022 |
6. Individual or Joint/Group Filing
(Check Applicable Line)
_X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security (Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code (Instr. 8)
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4. Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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Common Stock | 2/1/2022 | | A | | 1455 (1)(2) | A | $0 | 147501 | D | |
Common Stock | 2/1/2022 | | A | | 1073 (3) | A | $0 | 148574 | D | |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Trans. Date | 3A. Deemed Execution Date, if any | 4. Trans. 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 | 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 of Derivative Security: 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) | $21.27 | | | | | | | (4) | 2/1/2026 | Common Stock | 15000 | | 15000 | D | |
Stock Option (right to buy) | $14 | | | | | | | (4) | 7/30/2024 | Common Stock | 15000 | | 15000 | D | |
Stock Option (right to buy) | $25.39 | | | | | | | (4) | 3/26/2025 | Common Stock | 15000 | | 15000 | D | |
Stock Option (right to buy) | $66.06 | | | | | | | (4) | 2/1/2030 | Common Stock | 8024 | | 8024 | D | |
Explanation of Responses: |
(1) | This amendment is being filed to correct an error in the number of shares of Common Stock reported as acquired in the original Form 4. |
(2) | Each restricted stock unit represents a contingent right to receive one share of the issuer's common stock. The restricted stock units vest in full on the date of the issuer's annual stockholder meeting held in the current fiscal year. Vested shares will be delivered to the reporting person upon vesting. |
(3) | Each restricted stock unit represents a contingent right to receive one share of the issuer's common stock. The restricted stock units vested as to 269 shares on February 1, 2022. The remaining restricted stock units vest as to 268 shares on each of May 1, August 1, and November 1, of 2022. Vested shares will be delivered to the reporting person upon vesting. |
(4) | The option is immediately exercisable. |
Remarks: The Power of Attorney given by Mr. Sacks was previously filed with the U.S. Securities & Exchange Commission on February 3, 2017 as an exhibit to a statement on Form 4 filed by Mr. Sacks with respect to HealthEquity, Inc. and is hereby incorporated by reference. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Sacks Ian C/O HEALTHEQUITY, INC. 15 W. SCENIC POINTE DR., STE. 100 DRAPER, UT 84020 | X |
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Signatures
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/s/ Delano W. Ladd, attorney-in-fact | | 4/29/2022 |
**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 control number. |
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