0001104659-24-012291.txt : 20240208
0001104659-24-012291.hdr.sgml : 20240208
20240208161016
ACCESSION NUMBER: 0001104659-24-012291
CONFORMED SUBMISSION TYPE: 5
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20231231
FILED AS OF DATE: 20240208
DATE AS OF CHANGE: 20240208
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Mock Theresa L
CENTRAL INDEX KEY: 0001870249
ORGANIZATION NAME:
FILING VALUES:
FORM TYPE: 5
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-40501
FILM NUMBER: 24609169
MAIL ADDRESS:
STREET 1: C/O G3 VRM ACQUISITION CORP.
STREET 2: 420 BOYLSTON STREET, SUITE 302
CITY: BOSTON
STATE: MA
ZIP: 02116
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: iSpecimen Inc.
CENTRAL INDEX KEY: 0001558569
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMMERCIAL PHYSICAL & BIOLOGICAL RESEARCH [8731]
ORGANIZATION NAME: 08 Industrial Applications and Services
IRS NUMBER: 270480143
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 450 BEDFORD STREET
STREET 2: SUITE 1010
CITY: LEXINGTON
STATE: MA
ZIP: 02420
BUSINESS PHONE: 781-301-6700
MAIL ADDRESS:
STREET 1: 450 BEDFORD STREET
STREET 2: SUITE 1010
CITY: LEXINGTON
STATE: MA
ZIP: 02420
5
1
tm245072-1_5seq1.xml
OWNERSHIP DOCUMENT
X0508
5
2023-12-31
0
1
0
0001558569
iSpecimen Inc.
ISPC
0001870249
Mock Theresa L
C/O ISPECIMEN INC.
450 BEDFORD STREET
LEXINGTON
MA
02420
1
0
0
0
0
Non-Qualified Stock Options
1.37
3
2033-05-24
Common Stock
6672
6672
D
Each non-qualified stock option ("NSO") represents a contingent right to exercise for one share of common stock upon vesting subject to the terms and conditions set forth in the award of such NSOs by iSpecimen Inc. (the "Company") to the Reporting Person pursuant to a Nonqualified Stock Option Award Agreement (the "NSO Agreement") under the iSpecimen Inc. Amended and Restated 2021 Stock Incentive Plan, as amended. The stock options vested respect to 1,672 shares on June 30, 2023, an additional 2,500 shares on September 30, 2023 and the remaining 2,500 shares on December 31, 2023.
/s/ Theresa Mock
2024-02-08