0001209191-23-018261.txt : 20230313
0001209191-23-018261.hdr.sgml : 20230313
20230313183009
ACCESSION NUMBER: 0001209191-23-018261
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20230303
FILED AS OF DATE: 20230313
DATE AS OF CHANGE: 20230313
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Engelson Erik T.
CENTRAL INDEX KEY: 0001839384
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39976
FILM NUMBER: 23728637
MAIL ADDRESS:
STREET 1: 1412 62ND STREET
CITY: EMERYVILLE
STATE: CA
ZIP: 94608
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: 1315 63RD STREET
CITY: EMERYVILLE
STATE: CA
ZIP: 94608
BUSINESS PHONE: (814) 574-1546
MAIL ADDRESS:
STREET 1: 1315 63RD 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
2023-03-03
0
0001652724
Lucira Health, Inc.
LHDX
0001839384
Engelson Erik T.
C/O LUCIRA HEALTH INC.
1412 62ND ST
EMERYVILLE
CA
94608
1
1
0
0
President and Chief Executive
Common Stock
2023-03-03
4
M
0
574666
0.82
A
657948
D
Common Stock
2023-03-03
4
S
0
574666
1.03
D
83282
D
Common Stock
2023-03-03
4
S
0
60000
1.09
D
23282
D
Common Stock
46400
I
See Footnotes
Common Stock
191705
I
See Footnotes
Common Stock
0.82
2023-03-03
4
M
0
574666
0.00
D
2029-04-09
Common Stock
574666
0
D
The shares are held by the Elizabeth North Engelson Trust, dated January 17, 2001, for which Mr. Engelson serves as trustee.
The shares are held by Epic Pacific, LLC, of which Mr. Engelson is a Member. Mr. Engelson disclaims beneficial ownership of these securities
except to the extent of his pecuniary interest therein.
The shares subject to the option are immediately exercisable. 1/48th of the shares subject to the option shall vest monthly over the four years from the vesting commencement date.
/s/ Erik Engelson
2023-03-13