Initial Statement of Beneficial Ownership (3)
24 June 2022 - 07:11AM
Edgar (US Regulatory)
FORM 3
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UNITED STATES SECURITIES AND EXCHANGE
COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP
OF SECURITIES
|
OMB
APPROVAL
OMB Number: 3235-0104
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 * Haynes Omar |
2. Date of Event Requiring Statement
(MM/DD/YYYY)
6/13/2022
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3. Issuer Name and Ticker or Trading
Symbol XpresSpa Group, Inc. [XSPA] |
(Last)
(First)
(Middle)
C/O XPRESSPA GROUP, INC., 254 WEST 31ST STREET, 11TH
FLOOR |
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)_____
Director _____
10% Owner
___X___ Officer (give title
below) _____
Other (specify below)
VP Treas & Fi & Interim CFO
/ |
(Street)
NEW
YORK, NY 10001
(City)
(State)
(Zip)
|
5. 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 Beneficially
Owned
|
1.Title of Security
(Instr. 4) |
2. Amount of Securities Beneficially Owned
(Instr. 4) |
3. Ownership Form: Direct (D) or Indirect (I)
(Instr. 5) |
4. Nature of Indirect Beneficial Ownership
(Instr. 5) |
Common Stock |
548 |
D |
|
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible
securities)
|
1. Title of Derivate Security
(Instr. 4) |
2. Date Exercisable and Expiration Date
(MM/DD/YYYY) |
3. Title and Amount of Securities Underlying
Derivative Security
(Instr. 4) |
4. Conversion or Exercise Price of Derivative
Security |
5. Ownership Form of Derivative Security: Direct (D)
or Indirect (I)
(Instr. 5) |
6. Nature of Indirect Beneficial Ownership
(Instr. 5) |
Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
Employee stock option (right to buy) |
(1) |
4/20/2030 |
Common Stock |
33334 |
$1.53 |
D |
|
Employee stock option (right to buy) |
(2) |
1/22/2031 |
Common Stock |
108696 |
$1.61 |
D |
|
Employee stock option (right to buy) |
(3) |
4/20/2032 |
Common Stock |
100000 |
$1.43 |
D |
|
Explanation of
Responses: |
(1) |
The option is fully
vested. |
(2) |
The shares underlying this
option vest in in four equal installments over each of the four
anniversaries of the date of the grant, such that the options will
be fully vested as of January 22, 2025. |
(3) |
The shares underlying this
option vest in four installments beginning on March 20, 2023, on
March 20, 2024, on March 20, 2025 and will be fully vested as of
March 22, 2026. |
Remarks:
EXHIBIT 24 - Power of Attorney |
Reporting
Owners
|
Reporting Owner Name / Address |
Relationships
|
Director |
10% Owner |
Officer |
Other |
Haynes Omar
C/O XPRESSPA GROUP, INC.
254 WEST 31ST STREET, 11TH FLOOR
NEW YORK, NY 10001 |
|
|
VP Treas & Fi & Interim
CFO |
|
Signatures
|
/s/ Omar Haynes |
|
6/23/2022 |
**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 5(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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