SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person*
HIDARY JACK

(Last) (First) (Middle)
9001 BURDETTE RD.

(Street)
BETHESDA MD 20817

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
11/04/2021
3. Issuer Name and Ticker or Trading Symbol
Intelligent Medicine Acquisition Corp. [ IQMD ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
Officer (give title below) Other (specify below)
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Class B Common Stock (1) (1) Class A Common Stock 4,900,000(2)(3)(4) (1) I See Footnotes(2)(3)
Explanation of Responses:
1. As described in the issuer's registration statement on Form S-1 (File No. 333-260205) (the "Registration Statement") under the heading "Description of Securities--Founder Shares", the shares of Class B common stock will automatically convert into shares of Class A common stock at the time of the issuer's initial business combination on a one-for-one basis (subject to adjustment for stock splits, stock dividends, reorganizations, recapitalizations and the like) and subject to certain anti-dilution rights and have no expiration date.
2. Intelligent Medicine Sponsor LLC ("Sponsor") is the record holder of the shares of Class B common stock reported herein. Mr. Simon is a board member of the Sponsor along with Jack D. Hidary, Samir N. Khleif, and Geoffrey S. Ling. Each of Messrs. Simon, Hidary, Khleif, and Ling disclaim beneficial ownership of the reported securities other than to the extent of any pecuniary interest they may have therein, directly or indirectly.
3. Mr. Hidary has an indirect pecuniary interest in shares of Class B common stock of the issuer through membership interests in the Sponsor, over which Mr. Hidary does not have voting or dispositive control.
4. The shares of Class B common stock beneficially owned by the Sponsor include up to 675,000 shares subject to forfeiture to the extent the underwriter of the initial public offering of the issuer's securities does not exercise in full its over-allotment option as described in the Registration Statement.
/s/ Jack D. Hidary 11/04/2021
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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