Ownership Submission
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FORM 4/A
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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).
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES 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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OMB APPROVAL
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OMB Number:3235-0287Expires:January 31, 2005Estimated average burden hours per response...0.5
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1. Name and Address of Reporting Person *
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Green David A
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2. Issuer Name and Ticker or Trading Symbol
SeaStar Medical Holding Corp [ICU]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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_____ Director
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_____ 10% Owner
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_____ Officer (give title below)
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_____ Other (specify below)
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Chief Financial Officer /
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(Last)
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(First)
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(Middle)
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C/O SEASTAR MEDICAL HOLDING CORPORATION , 3513 BRIGHTON BLVD., SUITE 410
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3. Date of Earliest Transaction (Month/Day/Year)
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4. If Amendment, Date Original Filed(Month/Day/Year)
2024-09-16
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6. Individual or Join/Group Filing(Check Applicable Line)
_X_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security
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2. Transaction Date (Month/Day/Year)
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2A. Deemed Execution Date, if any (Month/Day/Year)
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3. Transaction Code
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4. Securities Acquired (A) or Disposed of (D)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
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6. Ownership Form: Direct (D) or Indirect (I)
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7. Nature of Indirect Beneficial Ownership
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Code
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V
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Amount
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(A) or (D)
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Price
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Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
(e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security
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2. Conversion or Exercise Price of Derivative Security
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3. Transaction Date (Month/Day/Year)
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3A. Deemed Execution Date, if any (Month/Day/Year)
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4. Transaction Code
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5. Number of Derivative Securities Acquired (A) or Disposed of (D)
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6. Date Exercisable and Expiration Date
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7. Title and Amount of Securities Underlying Derivative Security
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8. Price of Derivative Security
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9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s)
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10. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
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11. Nature of Indirect Beneficial Ownership
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Code
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V
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(A)
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(D)
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Date Exercisable
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Expriation Date
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Title
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Amount or Number of Shares
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Reporting Owners
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Reporting Owner Name / Address
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Relationships
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Director
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10% Owner
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Officer
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Other
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Green David A
C/O SEASTAR MEDICAL HOLDING CORPORATION
3513 BRIGHTON BLVD., SUITE 410
DENVER, CO80216
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Chief Financial Officer
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Signatures
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David A. Green
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2024-09-09
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**Signature of Reporting Person
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Date
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Explanation of Responses:
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(*)
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If the form is filed by more than one reporting person, see Instruction 5(b)(v).
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(**)
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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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(1)
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On April 16, 2024, a Form 4 (the "Original Report") was filed on behalf of the Reporting Person which inadvertently overstated the number of restricted stock unites ("RSUs") reported in Column 4 and Column 5 of Table I due to an administrative error. This Form 4 amendment is being filed to correct the aggregate number of RSUs issued to the Reporting Person as of the original transaction date from 30,100 RSUs (752,500 pre reverse split) to 18,000 RSUs (450,000 pre reverse split), and to report the grant of such RSUs on Table II, instead of Table I as set forth on the Original Report.
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(2)
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Each RSU represents a contingent right to receive one share of the Issuer's common stock.
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(3)
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On June 7, 2024, the Issuer effectuated a 1-for-25 reverse split of the Issuer's common stock. This amount represents the number of RSUs granted to the Reporting Person as of April 12, 2024 on a post-split basis.
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(4)
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The RSUs will vest, subject to continued service, on the first anniversary of Mr. Green's appointment date. Twenty-five percent (25%) of the RSUs will vest upon completion of one (1) year of service measured from January 10, 2024, and the remaining seventy-five percent (75%) of the RSUs will vest in a series of thirty-six (36) successive equal monthly installments upon completion of each additional month of service over the thirty-six (36)-month period measured from January 10, 2025.
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Note: File three copies of this Form, one of which must be manually signed. If space is insufficient,
See Instruction 6 for procedure.Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB number.
