Statement of Changes in Beneficial Ownership (4)
27 Mars 2023 - 10:10PM
Edgar (US Regulatory)
FORM 4
☐
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
|
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
|
OMB APPROVAL
OMB Number:
3235-0287
Estimated average burden hours per response...
0.5
|
|
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
|
|
1. Name and Address of Reporting Person
*
Hwang Kuk Hyoun |
2. Issuer Name and Ticker or Trading Symbol
Bellevue Life Sciences Acquisition Corp.
[
BLAC
]
|
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director __X__ 10% Owner __X__ Officer (give title below) _____ Other (specify below) Chief Executive Officer |
(Last)
(First)
(Middle)
10900 NE 4TH STREET, SUITE 2300 |
3. Date of Earliest Transaction
(MM/DD/YYYY)
3/23/2023 |
(Street)
BELLEVUE, WA 98004 |
4. If Amendment, Date Original Filed
(MM/DD/YYYY)
|
6. Individual or Joint/Group Filing
(Check Applicable Line)
_X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
|
(City)
(State)
(Zip)
|
Rule 10b5-1(c) Transaction Indication
☐
Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan that is intended to
satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10.
|
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
|
1.Title of Security (Instr. 3)
|
2. Trans. Date
|
2A. Deemed Execution Date, if any
|
3. Trans. Code (Instr. 8)
|
4. Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)
|
5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4)
|
6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
|
7. Nature of Indirect Beneficial Ownership (Instr. 4)
|
Code
|
V
|
Amount
|
(A) or (D)
|
Price
|
Common Stock | 3/23/2023 | | J(2) | | 20000 | D(2) | $0 | 2000500 (1)(2) | I | By Bellevue Global Life Sciences Investors LLC |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
|
1. Title of Derivate Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Trans. Date | 3A. Deemed Execution Date, if any | 4. Trans. Code (Instr. 8) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) | 6. Date Exercisable and Expiration Date | 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) | 8. Price of Derivative Security (Instr. 5) | 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) | 10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) |
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Warrant for Common Stock | $11.5 | 3/23/2023 | | J (3) | | | 20000 | (3) | (3) | Common Stock | 20000 | $0 | 370000 | I | By Bellevue Global Life Sciences Investors LLC |
Explanation of Responses: |
(1) | Represents shares of common stock held by Bellevue Global Life Sciences Investors LLC the sponsor of the Issuer (the "Sponsor"), whose general partner is Bellevue Capital Management LLC ("Bellevue Capital"). Kuk Hyoun Hwang is the managing partner of Bellevue Capital and has voting and dispositive power over the shares held by the Sponsor. |
(2) | Represents the shares transferred by the Sponsor to Mr. David Jin Yoo for service as Chief Financial Officer. |
(3) | Represents the warrant to purchase a total of 20,000 shares of the Issuer, transferred from the Sponsor to Mr. David Jin Yoo for his service as Chief Financial Officer. Each warrant will become exercisable 30 days after the Issuer's initial business combination. Each warrant will expire five years after the completion of the Issuer's initial business combination, or earlier upon redemption or liquidation. Each warrant entitles the holder to purchase one share of common stock at a price of $11.50 per share, subject to adjustments. |
Reporting Owners
|
Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Hwang Kuk Hyoun 10900 NE 4TH STREET, SUITE 2300 BELLEVUE, WA 98004 | X | X | Chief Executive Officer |
|
Signatures
|
/s/ Kuk Hyoun Hwang | | 3/27/2023 |
**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 4(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. |
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. |
Bellevue Life Sciences A... (NASDAQ:BLAC)
Graphique Historique de l'Action
De Oct 2024 à Nov 2024
Bellevue Life Sciences A... (NASDAQ:BLAC)
Graphique Historique de l'Action
De Nov 2023 à Nov 2024