Statement of Changes in Beneficial Ownership (4)
07 March 2023 - 08:16AM
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).
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL
OWNERSHIP OF SECURITIES
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OMB
APPROVAL
OMB Number: 3235-0287
Estimated average burden
hours per response... 0.5 |
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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
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1. Name
and Address of Reporting Person * Tapiero Daniel
M. |
2. Issuer Name and Ticker or Trading
Symbol Atlantic Coastal Acquisition Corp. [ ACAH
] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)__X__
Director _____
10% Owner
_____ Officer (give title
below) _____ Other
(specify below)
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(Last)
(First)
(Middle)
37 ROCK RIDGE AVE |
3. Date of Earliest Transaction (MM/DD/YYYY)
3/2/2023
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(Street)
GREENWICH, CT 06831
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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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, par value $0.0001 per
share |
3/2/2023 |
|
M(1) |
|
50000 |
A |
(1) |
50000 |
D |
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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 |
Class B Common Stock, par value $0.0001 per
share |
(2) |
3/2/2023 |
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M (1) |
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|
50000 |
(2) |
(2) |
Class A Common Stock, par value $0.0001 per
share |
50000 |
(2) |
0 |
D |
|
Explanation of
Responses: |
(1) |
On March 2, 2023 the
Reporting Person elected to exercise their right under Section
4.3(b)(i) of the Company's Amended and Restated Certificate of
Incorporation to convert 50,000 shares of Class B Common Stock into
50,000 shares of Class A Common Stock. |
(2) |
The Class B Common Stock are
convertible into the Issuer's Class A Common Stock on a one-for-one
basis, subject to adjustment pursuant to certain anti-dilution
rights, as described under the heading "Description of
Securities-Common Stock" in the Issuer's registration statement on
Form S-1 (File No. 333-253003) and the Issuer's DEF 14A filed
February 14th, 2023 and have no expiration date. |
Reporting
Owners
|
Reporting Owner Name / Address |
Relationships
|
Director |
10% Owner |
Officer |
Other |
Tapiero Daniel M.
37 ROCK RIDGE AVE
GREENWICH, CT 06831 |
X |
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|
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Signatures
|
By: /s/ Daniel M. Tapiero |
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3/6/2023 |
**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. |
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