Sec Form 3 Filing - Mullan Jill @ iSpecimen Inc. - 2021-06-16

Insider filing report for Changes in Beneficial Ownership
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FORM 3
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
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
Mullan Jill
2. Issuer Name and Ticker or Trading Symbol
iSpecimen Inc. [ ISPC]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X __ Director _____ 10% Owner
X __ Officer (give title below) _____ Other (specify below)
COO, Secretary, Treasurer
(Last) (First) (Middle)
C/O ISPECIMEN INC., 450 BEDFORD STREET
3. Date of Earliest Transaction (MM/DD/YY)
06/16/2021
(Street)
LEXINGTON, MA02420
4. If Amendment, Date Original Filed (MM/DD/YY)
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)
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1.Title of Security
(Instr. 3)
2. Transaction Date (MM/DD/YY) 2A. Deemed Execution Date, if any (MM/DD/YY) 3. Transaction 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 43,316 D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
( e.g. , puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security
(Instr. 3)
2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (MM/DD/YY) 3A. Deemed Execution Date, if any (MM/DD/YY) 4. Transaction 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
(MM/DD/YY)
7. Title and Amount of Underlying Securities
(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
Series A Preferred Stock ( 1 ) ( 1 ) ( 1 ) Common Stock 6,250 D
Option $ 1 ( 2 ) 07/12/2029 Common Stock 65,792 D
Option $ 1 ( 3 ) 06/29/2026 Common Stock 19,296 D
Option $ 1 ( 4 ) 01/31/2029 Common Stock 4,508 D
Bridge Note $ 5.6 ( 5 ) 06/30/2021 Common Stock 76,642 D
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Mullan Jill
C/O ISPECIMEN INC.
450 BEDFORD STREET
LEXINGTON, MA02420
X COO, Secretary, Treasurer
Signatures
/s/ Jill Mullan 06/17/2021
Signature of Reporting Person Date
Explanation of Responses:
( 1 )The preferred stock will automatically convert into shares of common stock upon the closing of the Issuer's initial public offering (the "IPO") and has no expiration date.
( 2 )Represents options granted on July 13, 2019 under the Issuer's 2010 Stock Incentive Plan, which were fully vested as of July 14, 2019
( 3 )Represents options granted on June 30, 2016 under the Issuer's 2013 Stock Incentive Plan, which were fully vested on June 30, 2019.
( 4 )Represents options granted on February 1, 2019 under the Issuer's 2013 Stock Incentive Plan, 25% of which was subject to a one-year cliff with the remaining 75% vested/to be vested quarterly over three years. The vesting commence date is February 1, 2019.
( 5 )The Bridge Note has a maturity date of June 30, 2021 and will automatically convert into 76,642 shares common stock at $8.00 upon the closing of the IPO.

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).
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