0001140361-22-023264.txt : 20220616 0001140361-22-023264.hdr.sgml : 20220616 20220616170814 ACCESSION NUMBER: 0001140361-22-023264 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220614 FILED AS OF DATE: 20220616 DATE AS OF CHANGE: 20220616 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: ROTHBERG JONATHAN M CENTRAL INDEX KEY: 0001076352 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39486 FILM NUMBER: 221021409 MAIL ADDRESS: STREET 1: C/O BUTTERFLY NETWORK, INC. STREET 2: 530 OLD WHITFIELD ST. CITY: GUILFORD STATE: CT ZIP: 06437 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Quantum-Si Inc CENTRAL INDEX KEY: 0001816431 STANDARD INDUSTRIAL CLASSIFICATION: MEASURING & CONTROLLING DEVICES, NEC [3829] IRS NUMBER: 851388175 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 530 OLD WHITFIELD STREET CITY: GUILFORD STATE: CT ZIP: 06437 BUSINESS PHONE: (203) 458-7100 MAIL ADDRESS: STREET 1: 530 OLD WHITFIELD STREET CITY: GUILFORD STATE: CT ZIP: 06437 FORMER COMPANY: FORMER CONFORMED NAME: HighCape Capital Acquisition Corp. DATE OF NAME CHANGE: 20200629 4 1 form4.xml FORM 4 X0306 4 2022-06-14 0001816431 Quantum-Si Inc QSI 0001076352 ROTHBERG JONATHAN M C/O QUANTUM-SI INCORPORATED 530 OLD WHITFIELD STREET GUILFORD CT 06437 true true true Interim CEO Class A Common Stock 2022-06-14 4 P 0 25561 3.0975 A 2568443 D Class A Common Stock 6230108 I By 2012 JMR Trust Common, LLC Class A Common Stock 1250000 I By NVR TR, LLC Class A Common Stock 1250000 I By JNR TR, LLC Class A Common Stock 1250000 I By JAR TR, LLC Class A Common Stock 1250000 I By GBR TR, LLC Class A Common Stock 1250000 I By EJR TR, LLC Class A Common Stock 1917067 I By 23rd Century Capital LLC Class A Common Stock 273422 I By Bonnie E Gould Rothberg MD Class B Common Stock 17943750 I By 4C Holdings I, LLC Class B Common Stock 1993750 I By 4C Holdings V, LLC Represents the weighted average purchase price per share. The shares were purchased at prices ranging from $3.065 to $3.1261 per share. Full information regarding the number of shares purchased at each price shall be provided upon request to the staff of the U.S. Securities and Exchange Commission, the Issuer, or a security holder of the Issuer. Dr. Rothberg is the sole manager of 4C Holdings I, LLC, 4C Holdings V, LLC, 2012 JMR Trust Common, LLC, NVR TR, LLC, JNR TR, LLC, JAR TR, LLC, GBR TR, LLC and EJR TR, LLC. Dr. Rothberg is the spouse of Bonnie E. Gould Rothberg MD and Dr. Rothberg's son is the manager of 23rd Century Capital LLC. Dr. Rothberg disclaims beneficial ownership of the shares held by his spouse and 23rd Century Capital LLC. Shares previously held by 2012 JMR Trust Common, LLC that were distributed to NVR TR, LLC, JNR TR, LLC, JAR TR, LLC, GBR TR, LLC and EJR TR, LLC. /s/ Samantha Silver, Attorney-in-Fact 2022-06-16