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*
Melbourne David Francis JR

(Last) (First) (Middle)
2 MILL AND MAIN PLACE
SUITE 395

(Street)
MAYNARD MA 01754

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
08/14/2023
3. Issuer Name and Ticker or Trading Symbol
AquaBounty Technologies, Inc. [ AQB ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
President
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)
Common Stock 106,781 D
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
Options to Purchase Common Stock 06/17/2020(1) 06/17/2029 Common Stock 15,000 $2.12 D
Options to Purchase Common Stock 01/02/2021(2) 01/02/2030 Common Stock 15,000 $2.47 D
Options to Purchase Common Stock 03/12/2023(3) 03/12/2030 Common Stock 12,799 $1.88 D
Options to Purchase Common Stock 03/10/2024(4) 03/10/2031 Common Stock 5,163 $6.72 D
Options to Purchase Common Stock 03/14/2025(5) 03/14/2032 Common Stock 20,153 $1.52 D
Options to Purchase Common Stock 03/09/2026(6) 03/09/2033 Common Stock 70,116 $0.36 D
Restricted Stock (7) (7) Common Stock 7,677 $0.00 D
Restricted Stock (8) (8) Common Stock 29,434 $0.00 D
Explanation of Responses:
1. Options to purchase common stock were granted on 06/17/2019 pursuant to the AquaBounty Technologies, Inc. 2016 Equity Incentive Plan and are fully vested.
2. Options to purchase common stock were granted on 01/02/2020 pursuant to the AquaBounty Technologies, Inc. 2016 Equity Incentive Plan and are fully vested.
3. Options to purchase common stock were granted on 3/12/2020 pursuant to the AquaBounty Technologies, Inc. 2016 Equity Incentive Plan and are fully vested.
4. Options to purchase common stock were granted on 3/10/2021 pursuant to the AquaBounty Technologies, Inc. 2016 Equity Incentive Plan and fully vest three years after the date of grant.
5. Options to purchase common stock were granted on 3/14/2022 pursuant to the AquaBounty Technologies, Inc. 2016 Equity Incentive Plan and fully vest three years after the date of grant.
6. Options to purchase common stock were issued 06/14/2023, pursuant to the AquaBounty Technologies, Inc. 2016 Equity Incentive Plan and fully vest on 03/09/2026.
7. Award of restricted stock granted on 3/14/2022 pursuant to the AquaBounty Technologies, Inc. 2016 Equity Incentive Plan that vested 7,678 shares immediately, with an additional 7,678 vested 03/14/23, and the final 7,677 vesting 2 years after the date of grant.
8. Award of restricted stock granted on 3/09/2023 pursuant to the AquaBounty Technologies, Inc. 2016 Equity Incentive Plan that vested 14,717 shares immediately, with an additional 14,717 vesting 1 year after the grant, and the final 14,717 vesting 2 years after the date of grant.
Remarks:
/s/ David A. Frank, Name: David A. Frank, attorney in-fact 08/18/2023
** 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).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
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