12/16/2024 | Press release | Distributed by Public on 12/16/2024 16:07
FORM 4
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 STATEMENT OF CHANGES IN 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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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |
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. | SEC 1474 (9-02) |
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 Underlying Securities (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 |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Bienstock Lee C/O DOCGO INC. 35 WEST 35TH STREET, FLOOR 6 NEW YORK, NY 10001 |
X | Chief Executive Officer |
/s/ Jerilyn Laskie, as Attorney-in-Fact for Lee Bienstock | 12/16/2024 |
**Signature of Reporting Person | Date |
* | 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). |
(1) | Represents restricted stock units ("RSUs") granted pursuant to the Issuer's 2021 Stock Incentive Plan (the "Plan"). The RSUs will vest in four equal annual installments on each of the first four anniversaries of December 12, 2024, subject to the terms of the Plan. Each RSU represents the right to receive, upon vesting, one share of Common Stock, subject to the terms of the Plan. |
(2) | In addition to the RSUs granted on December 12, 2024, this amount reflects (i) 109,289 RSUs granted pursuant to the Plan that will vest in three equal quarterly installments beginning on January 1, 2025; (ii) 73,427 RSUs granted pursuant to the Plan that will vest in two equal installments on each of March 28, 2025 and March 28, 2026; (iii) 91,463 RSUs granted pursuant to the Plan that will in three equal annual installments on each of May 12, 2025, May 12, 2026 and May 12, 2027; and (iv) 506,767 RSUs granted pursuant to the Plan that will vest in three equal annual installments on each of December 12, 2025, December 12, 2026 and December 12, 2027, in each case subject to the terms of the Plan. Each RSU represents the right to receive, upon vesting, one share of Common Stock, subject to the terms of the Plan. |
(3) | The transaction reported reflects the withholding of RSUs in satisfaction of the Reporting Person's tax liability. The RSUs were granted to the Reporting Person on December 12, 2023 pursuant to the Plan. |