<SEC-DOCUMENT>0001213900-21-058675.txt : 20211112
<SEC-HEADER>0001213900-21-058675.hdr.sgml : 20211112
<ACCEPTANCE-DATETIME>20211112160951
ACCESSION NUMBER:		0001213900-21-058675
CONFORMED SUBMISSION TYPE:	3
PUBLIC DOCUMENT COUNT:		1
CONFORMED PERIOD OF REPORT:	20211110
FILED AS OF DATE:		20211112
DATE AS OF CHANGE:		20211112

REPORTING-OWNER:	

	OWNER DATA:	
		COMPANY CONFORMED NAME:			Elfrink Willhem
		CENTRAL INDEX KEY:			0001893194

	FILING VALUES:
		FORM TYPE:		3
		SEC ACT:		1934 Act
		SEC FILE NUMBER:	001-41060
		FILM NUMBER:		211403523

	MAIL ADDRESS:	
		STREET 1:		2118 WALSH AVE
		STREET 2:		SUITE 210
		CITY:			SANTA CLARA
		STATE:			CA
		ZIP:			95050

ISSUER:		

	COMPANY DATA:	
		COMPANY CONFORMED NAME:			HeartBeam, Inc.
		CENTRAL INDEX KEY:			0001779372
		STANDARD INDUSTRIAL CLASSIFICATION:	SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841]
		IRS NUMBER:				474881450
		STATE OF INCORPORATION:			DE
		FISCAL YEAR END:			1231

	BUSINESS ADDRESS:	
		STREET 1:		2118 WALSH AVE., SUITE 210
		CITY:			SANTA CLARA
		STATE:			CA
		ZIP:			95050
		BUSINESS PHONE:		408-899-4443

	MAIL ADDRESS:	
		STREET 1:		2118 WALSH AVE., SUITE 210
		CITY:			SANTA CLARA
		STATE:			CA
		ZIP:			95050
</SEC-HEADER>
<DOCUMENT>
<TYPE>3
<SEQUENCE>1
<FILENAME>ownership.xml
<TEXT>
<XML>
<?xml version="1.0"?>
<ownershipDocument>

    <schemaVersion>X0206</schemaVersion>

    <documentType>3</documentType>

    <periodOfReport>2021-11-10</periodOfReport>

    <noSecuritiesOwned>0</noSecuritiesOwned>

    <issuer>
        <issuerCik>0001779372</issuerCik>
        <issuerName>HeartBeam, Inc.</issuerName>
        <issuerTradingSymbol>BEAT</issuerTradingSymbol>
    </issuer>

    <reportingOwner>
        <reportingOwnerId>
            <rptOwnerCik>0001893194</rptOwnerCik>
            <rptOwnerName>Elfrink Willhem</rptOwnerName>
        </reportingOwnerId>
        <reportingOwnerAddress>
            <rptOwnerStreet1>2118 WALSH AVE</rptOwnerStreet1>
            <rptOwnerStreet2>SUITE 210</rptOwnerStreet2>
            <rptOwnerCity>SANTA CLARA</rptOwnerCity>
            <rptOwnerState>CA</rptOwnerState>
            <rptOwnerZipCode>95050</rptOwnerZipCode>
            <rptOwnerStateDescription></rptOwnerStateDescription>
        </reportingOwnerAddress>
        <reportingOwnerRelationship>
            <isDirector>1</isDirector>
            <isOfficer>0</isOfficer>
            <isTenPercentOwner>0</isTenPercentOwner>
            <isOther>0</isOther>
            <officerTitle></officerTitle>
            <otherText></otherText>
        </reportingOwnerRelationship>
    </reportingOwner>

    <nonDerivativeTable>
        <nonDerivativeHolding>
            <securityTitle>
                <value>Common Stock</value>
            </securityTitle>
            <postTransactionAmounts>
                <sharesOwnedFollowingTransaction>
                    <value>105454</value>
                </sharesOwnedFollowingTransaction>
            </postTransactionAmounts>
            <ownershipNature>
                <directOrIndirectOwnership>
                    <value>D</value>
                </directOrIndirectOwnership>
            </ownershipNature>
        </nonDerivativeHolding>
    </nonDerivativeTable>

    <derivativeTable>
        <derivativeHolding>
            <securityTitle>
                <value>Convertible Promissory Note</value>
            </securityTitle>
            <conversionOrExercisePrice>
                <footnoteId id="F1"/>
            </conversionOrExercisePrice>
            <exerciseDate>
                <footnoteId id="F1"/>
            </exerciseDate>
            <expirationDate>
                <footnoteId id="F1"/>
            </expirationDate>
            <underlyingSecurity>
                <underlyingSecurityTitle>
                    <value>Common Stock</value>
                </underlyingSecurityTitle>
                <underlyingSecurityShares>
                    <value>60972</value>
                </underlyingSecurityShares>
            </underlyingSecurity>
            <ownershipNature>
                <directOrIndirectOwnership>
                    <value>D</value>
                </directOrIndirectOwnership>
            </ownershipNature>
        </derivativeHolding>
        <derivativeHolding>
            <securityTitle>
                <value>Convertible Promissory Note</value>
            </securityTitle>
            <conversionOrExercisePrice>
                <footnoteId id="F2"/>
            </conversionOrExercisePrice>
            <exerciseDate>
                <footnoteId id="F2"/>
            </exerciseDate>
            <expirationDate>
                <footnoteId id="F2"/>
            </expirationDate>
            <underlyingSecurity>
                <underlyingSecurityTitle>
                    <value>Common Stock</value>
                </underlyingSecurityTitle>
                <underlyingSecurityShares>
                    <value>106825</value>
                </underlyingSecurityShares>
            </underlyingSecurity>
            <ownershipNature>
                <directOrIndirectOwnership>
                    <value>I</value>
                </directOrIndirectOwnership>
                <natureOfOwnership>
                    <value>See Footnote</value>
                    <footnoteId id="F3"/>
                </natureOfOwnership>
            </ownershipNature>
        </derivativeHolding>
        <derivativeHolding>
            <securityTitle>
                <value>Convertible Promissory Note</value>
            </securityTitle>
            <conversionOrExercisePrice>
                <footnoteId id="F4"/>
            </conversionOrExercisePrice>
            <exerciseDate>
                <footnoteId id="F4"/>
            </exerciseDate>
            <expirationDate>
                <footnoteId id="F4"/>
            </expirationDate>
            <underlyingSecurity>
                <underlyingSecurityTitle>
                    <value>Common Stock</value>
                </underlyingSecurityTitle>
                <underlyingSecurityShares>
                    <value>164610</value>
                </underlyingSecurityShares>
            </underlyingSecurity>
            <ownershipNature>
                <directOrIndirectOwnership>
                    <value>I</value>
                </directOrIndirectOwnership>
                <natureOfOwnership>
                    <value>See Footnote</value>
                    <footnoteId id="F5"/>
                </natureOfOwnership>
            </ownershipNature>
        </derivativeHolding>
        <derivativeHolding>
            <securityTitle>
                <value>Stock option (right to buy)</value>
            </securityTitle>
            <conversionOrExercisePrice>
                <value>2.50</value>
            </conversionOrExercisePrice>
            <exerciseDate>
                <footnoteId id="F6"/>
            </exerciseDate>
            <expirationDate>
                <value>2031-06-15</value>
            </expirationDate>
            <underlyingSecurity>
                <underlyingSecurityTitle>
                    <value>Common Stock</value>
                </underlyingSecurityTitle>
                <underlyingSecurityShares>
                    <value>43636</value>
                </underlyingSecurityShares>
            </underlyingSecurity>
            <ownershipNature>
                <directOrIndirectOwnership>
                    <value>D</value>
                </directOrIndirectOwnership>
            </ownershipNature>
        </derivativeHolding>
        <derivativeHolding>
            <securityTitle>
                <value>Common Stock warrant (right to buy)</value>
            </securityTitle>
            <conversionOrExercisePrice>
                <value>2.75</value>
            </conversionOrExercisePrice>
            <exerciseDate>
                <footnoteId id="F7"/>
            </exerciseDate>
            <expirationDate>
                <value>2023-02-11</value>
            </expirationDate>
            <underlyingSecurity>
                <underlyingSecurityTitle>
                    <value>Common Stock</value>
                </underlyingSecurityTitle>
                <underlyingSecurityShares>
                    <value>3640</value>
                </underlyingSecurityShares>
            </underlyingSecurity>
            <ownershipNature>
                <directOrIndirectOwnership>
                    <value>D</value>
                </directOrIndirectOwnership>
            </ownershipNature>
        </derivativeHolding>
        <derivativeHolding>
            <securityTitle>
                <value>Common Stock warrant (right to buy)</value>
            </securityTitle>
            <conversionOrExercisePrice>
                <value>0.0003</value>
            </conversionOrExercisePrice>
            <exerciseDate>
                <footnoteId id="F8"/>
            </exerciseDate>
            <expirationDate>
                <value>2023-02-12</value>
            </expirationDate>
            <underlyingSecurity>
                <underlyingSecurityTitle>
                    <value>Common Stock</value>
                </underlyingSecurityTitle>
                <underlyingSecurityShares>
                    <value>43636</value>
                </underlyingSecurityShares>
            </underlyingSecurity>
            <ownershipNature>
                <directOrIndirectOwnership>
                    <value>D</value>
                </directOrIndirectOwnership>
            </ownershipNature>
        </derivativeHolding>
    </derivativeTable>

    <footnotes>
        <footnote id="F1">Represents $256,082.40 of outstanding principal and interest calculated through November 10, 2021. The note will convert into 60,972 shares of Common Stock upon the closing of the Issuer's initial public offering of Common Stock (the &quot;IPO&quot;).</footnote>
        <footnote id="F2">Represents $448,665.00 of outstanding principal and interest calculated through November 10, 2021. The note will convert into 106,825 shares of Common Stock upon the closing of the IPO.</footnote>
        <footnote id="F3">The Convertible Promissory Note is held by the Elfrink Living Trust, of which the Reporting Person is the trustee.</footnote>
        <footnote id="F4">Represents $691,362.00 of outstanding principal and interest calculated through November 10, 2021. The note will convert into 164,610 shares of Common Stock upon the closing of the IPO.</footnote>
        <footnote id="F5">The Convertible Promissory Note is held by WPE Ventures Partnership, of which the Reporting Person is the managing partner.</footnote>
        <footnote id="F6">One forty-eighth of the shares subject to the option vest on July 15, 2021 and each one-month anniversary thereafter, subject to the Reporting Person continuing as a service provider through each such date.</footnote>
        <footnote id="F7">All of the shares subject to the warrant are fully vested and exercisable as of the date hereof.</footnote>
        <footnote id="F8">The shares subject to the warrant are exercisable upon the earliest to occur of several events, including the closing of the IPO and the Issuer having a market capitalization of at least $50,000,000 for five consecutive business days.</footnote>
    </footnotes>

    <ownerSignature>
        <signatureName>/s/ Willem Elfrink</signatureName>
        <signatureDate>2021-11-10</signatureDate>
    </ownerSignature>
</ownershipDocument>
</XML>
</TEXT>
</DOCUMENT>
</SEC-DOCUMENT>
