Statement of Changes in Beneficial Ownership (4)
November 14 2022 - 8:03AM
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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OMB APPROVAL
OMB Number:
3235-0287
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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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Ianelli Christopher |
2. Issuer Name and Ticker or Trading Symbol
iSpecimen Inc.
[
ISPC
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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 ISPECIMEN INC., 450 BEDFORD STREET |
3. Date of Earliest Transaction
(MM/DD/YYYY)
10/24/2022 |
(Street)
LEXINGTON, MA 02420
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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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 (1) | 10/24/2022 | | J(1) | | 18229 | D | (2) | 424514 | 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 |
Option | (3) | 10/24/2022 | 10/24/2022 | J | | | 564 | (3) | 10/24/2022 | Common Stock | 564 | (3) | 845 | D | |
Explanation of Responses: |
(1) | Pursuant to certain separation agreement, dated October 24, 2022, by and between the issuer and the reporting person, (i) an aggregate of 13,021 restricted stock units of the issuer (the "RSUs"), which were previously awarded to the reporting person but not settled, were settled at an accelerated vesting schedule and as a result, 13,021 shares of common stock were issued to the reporting person; and (ii) 18,229 RSUs, which were previously awarded to the reporting person and not settled, were forfeited. |
(2) | The RSUs were previously awarded as compensation to the reporting person for his former service as an officer of the issuer. |
(3) | Represents unvested stock options that were forfeited upon the termination of employment of the reporting person with the issuer. Stock options exercisable for an aggregate of 845 shares that were vested on the date of termination of employment of the reporting person will expire on January 22, 2023, if not exercised by the reporting person before that date. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Ianelli Christopher C/O ISPECIMEN INC. 450 BEDFORD STREET LEXINGTON, MA 02420 | X |
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Signatures
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/s/ Christopher Ianelli | | 11/14/2022 |
**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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