0001213900-22-015476.txt : 20220328
0001213900-22-015476.hdr.sgml : 20220328
20220328145730
ACCESSION NUMBER: 0001213900-22-015476
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20220323
FILED AS OF DATE: 20220328
DATE AS OF CHANGE: 20220328
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Fisher Kenneth R
CENTRAL INDEX KEY: 0001812485
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-41031
FILM NUMBER: 22775093
MAIL ADDRESS:
STREET 1: 67 PROSPECT STREET
CITY: PEABODY
STATE: MA
ZIP: 01960
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Bluejay Diagnostics, Inc.
CENTRAL INDEX KEY: 0001704287
STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841]
IRS NUMBER: 473552922
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 360 MASSACHUSETTS AVENUE, SUITE 203
CITY: ACTON
STATE: MA
ZIP: 01720
BUSINESS PHONE: (978) 631-0152
MAIL ADDRESS:
STREET 1: 360 MASSACHUSETTS AVENUE, SUITE 203
CITY: ACTON
STATE: MA
ZIP: 01720
4
1
ownership.xml
X0306
4
2022-03-23
0
0001704287
Bluejay Diagnostics, Inc.
BJDX
0001812485
Fisher Kenneth R
C/O BLUEJAY DIAGNOSTICS, INC
360 MASSACHUSETTS AVENUE, SUITE 203
ACTON
MA
01720
0
1
0
0
Chief Financial Officer
Option (right to buy)
1.31
2022-03-23
4
A
0
65000
A
2032-03-23
Common Stock
65000
65000
D
Of the option grant, 5,000 shares were fully-vested on the Transaction Date and 60,000 shares will vest in three equal annual installments beginning on the first anniversary of the Transaction Date, subject to the grantee's continued service to the Company on each vesting date.
Issued in connection with the reporting person's employment with the Company.
/s/ Kenneth Fisher
2022-03-28