Statement of Changes in Beneficial Ownership (4)
03 Dezember 2021 - 11:15PM
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
|
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OMB Number: 3235-0287
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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 * McNeice Paul
Francis |
2. Issuer Name and Ticker or Trading
Symbol American Well Corp [ AMWL ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)_____
Director _____
10% Owner
__X__ Officer (give title
below) _____ Other
(specify below)
Vice President of Accounting |
(Last)
(First)
(Middle)
C/O AMERICAN WELL CORPORATION, 75 STATE STREET, 26TH
FLOOR |
3. Date of Earliest Transaction (MM/DD/YYYY)
12/1/2021
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(Street)
BOSTON, MA 02109
(City)
(State)
(Zip)
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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 |
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 |
Class A Common Stock |
12/1/2021 (1) |
|
S(1) |
|
248 |
D |
$6.4215 |
38582 |
D |
|
Class A Common Stock |
12/1/2021 (1) |
|
S(1) |
|
1046 |
D |
$6.4215 |
37536 |
D |
|
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 |
Explanation of
Responses: |
(1) |
The sales reported in this
Form 4 were effected pursuant to the terms of a Rule 10b5-1 trading
plan adopted by the reporting person on December 31, 2020, as
amended on January 29, 2021, and were made in order to pay the tax
liability arising from the vesting and settlement of restricted
stock units on December 1, 2021. |
Reporting
Owners
|
Reporting Owner Name / Address |
Relationships
|
Director |
10% Owner |
Officer |
Other |
McNeice Paul Francis
C/O AMERICAN WELL CORPORATION
75 STATE STREET, 26TH FLOOR
BOSTON, MA 02109 |
|
|
Vice President of Accounting |
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Signatures
|
/s/ Bradford Gay, as attorney-in-fact for Paul
McNeice |
|
12/3/2021 |
**Signature of Reporting
Person |
Date |
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