| FORM 3 | UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES 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*
(Street)
| 2. Date of Event Requiring Statement (Month/Day/Year) 09/20/2021 | 3. Issuer Name and Ticker or Trading Symbol MedAvail Holdings, Inc. [ MDVL ] | |||||||||||||
| 4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
| 5. 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 Beneficially Owned | |||
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| 1. Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
| Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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| 1. Title of Derivative Security (Instr. 4) | 2. Date Exercisable and Expiration Date (Month/Day/Year) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 6. Nature of Indirect Beneficial Ownership (Instr. 5) | ||
| Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
| Stock Option (Right to Buy) | (1) | 09/20/2031 | Common Stock | 184,912 | 3.19 | D | |
| Restricted Stock Units | (2) | 09/20/2031 | Common Stock | 101,881 | 3.19 | D | |
| Explanation of Responses: |
| 1. 1. Option granted under the Issuer's 2020 Equity Incentive Plan (the "ESOP Plan"). One forty-eighth (1/48th) of the shares subject to the Option shall be scheduled to vest each month after the Vesting Commencement Date on the same day of the month as the Vesting Commencement Date (or the last day of the month, if there is no corresponding day in a given month), in each case subject to Executive remaining a Service Provider (as defined in the ESOP Plan) through the applicable vesting date. "Vesting Commencement Date" shall mean September 20, 2021. |
| 2. 2. RSU granted under the Issuer's 2020 Equity Incentive Plan. One third (1/3rd) of the shares subject to the RSU shall be scheduled to vest on each of the one (1), two (2), and three (3) year anniversaries of the Vesting Commencement Date such that the RSU shall be scheduled to become fully vested on the three (3) year anniversary of the Vesting Commencement Date, in each case subject to Executive remaining a Service Provider (as defined in the ESOP Plan) through the applicable vesting date. "Vesting Commencement Date" shall mean September 1, 2021. |
| Remarks: |
| /s/ Ramona Seabaugh | 09/22/2021 | |
| ** 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 5 (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. | ||
