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*
Seabaugh Ramona

(Last) (First) (Middle)
12343 N 129TH PL

(Street)
SCOTTSDALE AZ 85259

(City) (State) (Zip)
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)
Director 10% Owner
X Officer (give title below) Other (specify below)
Chief Financial Officer
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)
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
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).
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