Statement of Changes in Beneficial Ownership (4)
05 Januar 2022 - 03:45PM
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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APPROVAL
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 * Schell Steven |
2. Issuer Name and Ticker or Trading
Symbol Heliogen, Inc. [ HLGN ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)_____
Director _____
10% Owner
__X__ Officer (give title
below) _____ Other
(specify below)
Chief Technology Officer |
(Last)
(First)
(Middle)
C/O HELIOGEN, INC., 130 W UNION STREET |
3. Date of Earliest Transaction (MM/DD/YYYY)
12/30/2021
|
(Street)
PASADENA, CA 91103
(City)
(State)
(Zip)
|
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 |
Common Stock |
12/30/2021 |
|
A |
|
150996 (1) |
A |
$0.00 |
150996 |
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 |
Employee Stock Option (right to
buy) |
$0.35 |
12/30/2021 |
|
A |
|
1509964 |
|
(2) |
7/21/2030 |
Common Stock |
1509964 |
$0.00 (3) |
1509964 |
D |
|
Employee Stock Option (right to
buy) |
$0.18 |
12/30/2021 |
|
A |
|
1006643 |
|
(4) |
2/5/2029 |
Common Stock |
1006643 |
$0.00 (3) |
1006643 |
D |
|
Employee Stock Option (right to
buy) |
$0.18 |
12/30/2021 |
|
A |
|
201328 |
|
(5) |
12/5/2028 |
Common Stock |
201328 |
$0.00 (3) |
201328 |
D |
|
Explanation of
Responses: |
(1) |
These shares are represented
by restricted stock units ("RSUs") issued by Heliogen, Inc., a
Delaware corporation ("Legacy Heliogen") and assumed by the Issuer
on December 30, 2021 pursuant to that certain Business Combination
Agreement ("Merger Agreement"), dated as of July 6, 2021, by and
among Athena Technology Acquisition Corp., a Delaware corporation
("Athena"), HelioMax Merger Sub, Inc., a Delaware corporation and a
wholly-owned subsidiary of Athena, and Legacy Heliogen. Each RSU
represents a contingent right to receive one share of the Common
Stock of the Issuer. Six and one-quarter percent (6.25%) of the
shares underlying the RSUs vest in quarterly installments with the
first installment vesting on March 15, 2022, subject to the
Reporting Person's continuous service. |
(2) |
The shares shall vest in 48
equal monthly installments commencing on July 22, 2020, subject to
the Reporting Person's continuous service. |
(3) |
Represents options issued by
Legacy Heliogen and assumed by the Issuer on December 30, 2021
pursuant to the Merger Agreement. |
(4) |
One quarter (25%) of the
shares vested on February 6, 2020, and the remainder of the shares
shall vest in 36 equal monthly installments, subject to the
Reporting Person's continuous service. |
(5) |
The shares shall vest in 48
equal monthly installments commencing on December 6, 2018, subject
to the Reporting Person's continuous service. |
Reporting
Owners
|
Reporting Owner Name / Address |
Relationships
|
Director |
10% Owner |
Officer |
Other |
Schell Steven
C/O HELIOGEN, INC.
130 W UNION STREET
PASADENA, CA 91103 |
|
|
Chief Technology Officer |
|
Signatures
|
/s/ Dorothy Vinsky,
Attorney-in-Fact |
|
1/5/2022 |
**Signature of Reporting
Person |
Date |
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