Statement of Changes in Beneficial Ownership (4)
22 Junho 2022 - 5:11PM
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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HAMMERGREN JOHN H |
2. Issuer Name and Ticker or Trading Symbol
Butterfly Network, Inc.
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BFLY
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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 BUTTERFLY NETWORK, INC., 530 OLD WHITFIELD STREET |
3. Date of Earliest Transaction
(MM/DD/YYYY)
6/17/2022 |
(Street)
GUILFORD, CT 06437
(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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Class A Common Stock | 6/17/2022 | | A | | 48231 (1) | A | $0.00 | 61388 | D | |
Class A Common Stock | | | | | | | | 120099 | I | Held by Triumph Ventures LP (2) |
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 |
Explanation of Responses: |
(1) | Consists of restricted stock units ("RSUs"). Each RSU represents the right to receive one share of Class A common stock upon vesting. The RSUs were issued to the Reporting Person as the annual grant to nonemployee directors pursuant to the Issuer's Amended and Restated Nonemployee Director Compensation Policy for services to be rendered to the Issuer as a member of its Board of Directors. The RSUs vest in full on the date of the Issuer's 2023 Annual Stockholders Meeting, subject to the Reporting Person's continued service on the Board of Directors on such date. |
(2) | Mr. Hammergren is the President of The Stoneyfield Group LLC, the General Partner of Triumph Ventures LP. Mr. Hammergren disclaims beneficial ownership of the securities held by Triumph Ventures LP except to the extent of his pecuniary interest therein. |
Remarks: Exhibit 24.1 - Power of Attorney |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
HAMMERGREN JOHN H C/O BUTTERFLY NETWORK, INC. 530 OLD WHITFIELD STREET GUILFORD, CT 06437 | X |
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Signatures
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/s/ Lawrence T. Weiss, Attorney-in-Fact | | 6/22/2022 |
**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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