SEC Form 3
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*
Jacobs Bette

(Last) (First) (Middle)
C/O SHUTTLE PHARMACEUTICALS HOLDING
1 RESEARCH COURT, SUITE 450

(Street)
ROCKVILLE MD 20850

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
10/28/2022
3. Issuer Name and Ticker or Trading Symbol
Shuttle Pharmaceuticals Holdings, Inc. [ SHPH ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
Officer (give title below) Other (specify below)
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
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)
COMMON STOCK 35,587(1) D
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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
Explanation of Responses:
1. The undersigned became a Reporting Person subject to Section 16 reporting on October 28, 2022, the date on which the Reporting Person commenced service as a director of Shuttle Pharmaceuticals Holdings, Inc. ("Company"). Upon her appointment to the position of director, on October 28, 2022 (the "Grant Date"), the Company awarded the Reporting Person 35,587 Restricted Stock Units ("RSUs"). One-third of the RSUs became vested on the grant date, with the remaining two-thirds subject to vesting in substantially equal installments on the first and second year anniversary of the Grant Date.
/s/ Bette Jacobs 11/09/2022
** 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 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.
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