Orchestra BioMed | SEC Filing

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SEC FORM 4 SEC Form 4

FORM 4

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
or Section 30(h) of the Investment Company Act of 1940

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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).

1. Name and Address of Reporting Person^*

Smith Geoffrey Wade

(Last)

(First)

(Middle)

C/O ORCHESTRA BIOMED HOLDINGS, INC.

150 UNION SQUARE DRIVE

(Street)

NEW HOPE

18938

(City)

(State)

(Zip)

2. Issuer Name and Ticker or Trading Symbol
Orchestra BioMed Holdings, Inc. [ OBIO ]

5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)

X	Director	10% Owner
	Officer (give title below)	Other (specify below)

3. Date of Earliest Transaction (Month/Day/Year)
04/12/2023

4. If Amendment, Date of Original Filed (Month/Day/Year)

6. Individual or Joint/Group Filing (Check Applicable Line)

X	Form filed by One Reporting Person
	Form filed by More than One Reporting Person

Rule 10b5-1(c) Transaction Indication

Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan that is intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10.

Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3)	2. Transaction Date (Month/Day/Year)	2A. Deemed Execution Date, if any (Month/Day/Year)	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)
1. Title of Security (Instr. 3)	2. Transaction Date (Month/Day/Year)	2A. Deemed Execution Date, if any (Month/Day/Year)	Code	V	Amount	(A) or (D)	Price		6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)	7. Nature of Indirect Beneficial Ownership (Instr. 4)
Common Stock, par value $0.0001 per share ("Common Stock")	04/12/2023		M⁽¹⁾⁽²⁾		758	A	⁽¹⁾⁽²⁾	4,246	D
Common Stock, par value $0.0001 per share ("Common Stock")	04/12/2023		M⁽¹⁾⁽²⁾		43,761	A	⁽¹⁾⁽²⁾	245,080	I	By Ascent Biomedical Ventures II NY, LP⁽³⁾
Common Stock, par value $0.0001 per share ("Common Stock")	04/12/2023		M⁽¹⁾⁽²⁾		228,073	A	⁽¹⁾⁽²⁾	1,277,297	I	By Ascent Biomedical Ventures II, LP⁽³⁾
Common Stock, par value $0.0001 per share ("Common Stock")	04/12/2023		M⁽¹⁾⁽²⁾		55,783	A	⁽¹⁾⁽²⁾	312,406	I	By Ascent Biomedical Ventures Synecor, LP⁽³⁾

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 (Month/Day/Year)	3A. Deemed Execution Date, if any (Month/Day/Year)	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 (Month/Day/Year)		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: Direct (D) or Indirect (I) (Instr. 4)	11. Nature of Indirect Beneficial Ownership (Instr. 4)
1. Title of Derivative Security (Instr. 3)	2. Conversion or Exercise Price of Derivative Security	3. Transaction Date (Month/Day/Year)	3A. Deemed Execution Date, if any (Month/Day/Year)	Code	V	(A)	(D)	Date Exercisable	Expiration Date	Title	Amount or Number of Shares	8. Price of Derivative Security (Instr. 5)		10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)	11. Nature of Indirect Beneficial Ownership (Instr. 4)
Right to Receive Earnout Shares	⁽¹⁾⁽²⁾	04/12/2023		M⁽¹⁾⁽²⁾			758	⁽¹⁾⁽²⁾	⁽¹⁾⁽²⁾	Common Stock	758	⁽¹⁾⁽²⁾	758	D
Right to Receive Earnout Shares	⁽¹⁾⁽²⁾	04/12/2023		M⁽¹⁾⁽²⁾			43,761	⁽¹⁾⁽²⁾	⁽¹⁾⁽²⁾	Common Stock	43,761	⁽¹⁾⁽²⁾	43,761	I	By Ascent Biomedical Ventures II NY, LP⁽³⁾
Right to Receive Earnout Shares	⁽¹⁾⁽²⁾	04/12/2023		M⁽¹⁾⁽²⁾			228,073	⁽¹⁾⁽²⁾	⁽¹⁾⁽²⁾	Common Stock	228,073	⁽¹⁾⁽²⁾	228,073	I	By Ascent Biomedical Ventures II, LP⁽³⁾
Right to Receive Earnout Shares	⁽¹⁾⁽²⁾	04/12/2023		M⁽¹⁾⁽²⁾			55,783	⁽¹⁾⁽²⁾	⁽¹⁾⁽²⁾	Common Stock	55,783	⁽¹⁾⁽²⁾	55,783	I	By Ascent Biomedical Ventures Synecor, LP⁽³⁾

Explanation of Responses:

1. Pursuant to the Agreement and Plan of Merger, dated as of July 4, 2022 (and as subsequently amended) by and among the Issuer and certain other parties named therein (the "Merger Agreement"), the Reporting Person has the contingent right to receive, for no additional consideration, the Reporting Person's Pro Rata Portion (as such term is defined in the Merger Agreement ) of 8,000,000 shares of common stock of the Issuer (the "Earnout Shares") if, at any time from January 26, 2023 until January 26, 2028, the volume-weighted average price of the common stock of the Issuer is greater than or equal to (i) with respect to 4,000,000 Earnout Shares, $15.00 per share over any 20 trading days within any 30-trading day period (the "Initial Milestone Event") and (ii) with respect to 4,000,000 Earnout Shares, $20.00 per share over any 20 trading days within any 30-trading day period.

2. The Initial Milestone Event occurred on April 12, 2023 and the Reporting Person's Pro Rata Portion of 4,000,000 shares of Common Stock were issued to the Reporting Person on April 19, 2023 in accordance with the Merger Agreement.

3. The Reporting Person is a managing member of ABV, LLC, which serves as general partner to Ascent Biomedical Ventures II NY, LP, Ascent Biomedical Ventures II, LP and Ascent Biomedical Ventures Synecor, LP. The Reporting Person disclaims beneficial ownership of the securities reported herein, except to the extent of his pecuniary interest, if any, therein.

	/s/ Todd Finger, Attorney-in-Fact	05/08/2023
	** 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).
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