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 |
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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). |
1. Name and Address of Reporting Person*
(Street)
| 2. Issuer Name and Ticker or Trading Symbol Future Health ESG Corp. [ FHLT ] | 5. Relationship of Reporting Person(s) to Issuer (Check all applicable)
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3. Date of Earliest Transaction (Month/Day/Year) 10/24/2021 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed (Month/Day/Year) | 6. Individual or Joint/Group Filing (Check Applicable Line)
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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) | 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, par value $0.0001 per share | 10/24/2021 | D(1) | 93,750(1) | D | $0(1) | 10,101 | I | See footnote(2) | ||
Common stock, par value $0.0001 per share | 10/24/2021 | D(3) | 73,406(3) | D | $0(3) | 489,375 | I | See footnote(4) | ||
Common stock, par value $0.0001 per share | 10/24/2021 | D(5) | 1,485(5) | D | $0(5) | 9,900 | I | See footnote(6) | ||
Common stock, par value $0.0001 per share | 10/24/2021 | D(7) | 44,042(7) | D | $0(7) | 293,611 | I | See footnote(8) |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||||||||||
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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. Represents the Reporting Person's pecuniary interest in shares forfeited by MB Equity, LLC to the Issuer on October 24, 2021 for no consideration in connection with the expiration of the underwriters' over-allotment option. |
2. The shares are held directly by MB Equity, LLC. The Reporting Person disclaims beneficial ownership of the securities held by MB Equity, LLC other than the reported securities except to the extent of his pecuniary interest therein. |
3. On October 24, 2021, BEA Holdings, LLC forfeited 73,406 shares to the Issuer for no consideration in connection with the expiration of the underwriters' over-allotment option. |
4. The shares are held directly by BEA Holdings, LLC, of which the Reporting Person is the sole manager. |
5. Represents the Reporting Person's pecuniary interest in shares forfeited by hc1.com, Inc. to the Issuer on October 24, 2021 for no consideration in connection with the expiration of the underwriters' over-allotment option. |
6. The shares are held directly by hc1.com, Inc., of which the Reporting Person is the Chief Executive Officer and Chairman. The Reporting Person disclaims beneficial ownership of the reported securities except to the extent of his pecuniary interest therein. The Reporting Person disclaims beneficial ownership of the securities held by hc1.com, Inc. other than the reported securities except to the extent of his pecuniary interest therein. |
7. Represents the Reporting Person's pecuniary interest in shares forfeited by Future Health ESG Associates 1, LLC to the Issuer on October 24, 2021 for no consideration in connection with the expiration of the underwriters' over-allotment option. |
8. The shares are held directly by Future Health ESG Associates 1, LLC, of which the Reporting Person is a manager, and indirectly by b2 Holdings, LLC, of which the Reporting Person is the manager, BEA Holdings, LLC, and three individual retirement accounts in the names of two of the Reporting Person's daughters and the Reporting Person's son, respectively. The Reporting Person disclaims beneficial ownership of the reported securities except to the extent of his pecuniary interest therein. The Reporting Person disclaims beneficial ownership of the securities held by Future Health ESG Associates 1, LLC other than the reported securities except to the extent of his pecuniary interest therein. |
/s/ Travis A. Morgan, as attorney-in-fact for Bradley Bostic | 10/26/2021 | |
** 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. |