0001209191-21-009039.txt : 20210209 0001209191-21-009039.hdr.sgml : 20210209 20210209195026 ACCESSION NUMBER: 0001209191-21-009039 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210209 FILED AS OF DATE: 20210209 DATE AS OF CHANGE: 20210209 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Lamond David CENTRAL INDEX KEY: 0001770790 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39976 FILM NUMBER: 21608638 MAIL ADDRESS: STREET 1: C/O CORTEXYME, INC. STREET 2: 269 EAST GRAND AVE. CITY: SOUTH SAN FRANCISCO STATE: CA ZIP: 94080 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Lucira Health, Inc. CENTRAL INDEX KEY: 0001652724 STANDARD INDUSTRIAL CLASSIFICATION: IN VITRO & IN VIVO DIAGNOSTIC SUBSTANCES [2835] IRS NUMBER: 272491037 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1412 62ND STREET CITY: EMERYVILLE STATE: CA ZIP: 94608 BUSINESS PHONE: (814) 574-1546 MAIL ADDRESS: STREET 1: 1412 62ND STREET CITY: EMERYVILLE STATE: CA ZIP: 94608 FORMER COMPANY: FORMER CONFORMED NAME: DiAssess Inc. DATE OF NAME CHANGE: 20150908 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2021-02-09 0 0001652724 Lucira Health, Inc. LHDX 0001770790 Lamond David 1412 62ND STREET EMERYVILLE CA 94608 1 0 0 0 Common Stock 2021-02-09 4 C 0 53629 A 53629 I See footnote Common Stock 2021-02-09 4 C 0 92756 A 146385 I See footnote Common Stock 125281 D Series B Preferred Stock 2021-02-09 4 C 0 53629 0.00 D 02/09/2021 53629 0 I See footnote Series C Preferred Stock 2021-02-09 4 C 0 92756 0.00 D 02/09/2021 92756 0 I See footnote Each share of Series B Preferred Stock and Series C Preferred Stock (the "Preferred Stock") automatically converted on a one-for-one basis into Common Stock at the closing of the Issuer's initial public offering, for no additional consideration. The shares of Preferred Stock had no expiration date. The shares are held by Blue Devil Trust, for which Mr. Lamond serves as a trustee. /s/ Dan George, Attorney-in-Fact for David Lamond 2021-02-09