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)
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2. Date of Event Requiring Statement
(Month/Day/Year) 11/27/2023 |
3. Issuer Name and Ticker or Trading Symbol
Better Therapeutics, Inc. [ BTTX ] |
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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5. If Amendment, Date of Original Filed
(Month/Day/Year) |
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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) |
Common Stock | 14,350(1) | D |
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) | (2) | 10/27/2031 | Common Stock | 16,100 | $10.97 | D | |
Stock Option (Right to Buy) | (3) | 03/31/2032 | Common Stock | 11,100 | $1.97 | D | |
Stock Option (Right to Buy) | (4) | 02/28/2033 | Common Stock | 9,650 | $1.14 | D |
Explanation of Responses: |
1. The shares represent restricted stock units (each, an "RSU") granted on April 5, 2023, which vest as to 1/2 of the shares on March 24, 2024 and the remaining shares vest on March 24, 2025, provided the Reporting Person continues to have a service relationship with Issuer on each vesting date. Each RSU represents a contingent right to receive one share of the Issuer's Common Stock. |
2. The stock option vests as to 1/4 of the shares subject to the stock option on September 27, 2022 and the remaining shares vest in 36 equal monthly installments thereafter, provided the Reporting Person continues to have a service relationship with Issuer on each vesting date. The stock option was granted on October 28, 2021. |
3. The stock option vests as to 1/4 of the shares subject to the stock option on April 1, 2023 and the remaining shares vest in 36 equal monthly installments thereafter, provided the Reporting Person continues to have a service relationship with Issuer on each vesting date. The stock option was granted on April 1, 2022. |
4. The stock option vests as to 1/4 of the shares subject to the stock option on March 1, 2024 and the remaining shares vest in 36 equal monthly installments thereafter, provided the Reporting Person continues to have a service relationship with Issuer on each vesting date. The stock option was granted on March 1, 2023. |
Remarks: |
Exhibit 24 - Power of Attorney |
/s/ Leslie A. Miller | 12/07/2023 | |
** 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. |