SEC FORM 3/A

SEC Form 3

FORM 3

UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF 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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1. Name and Address of Reporting Person^*

Vajdic Branislav

(Last)

(First)

(Middle)

2118 WALSH AVE, SUITE 210

(Street)

SANTA CLARA

95050

(City)

(State)

(Zip)

2. Date of Event Requiring Statement (Month/Day/Year)
11/10/2021

3. Issuer Name and Ticker or Trading Symbol
HeartBeam, Inc. [ BEAT ]

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

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

5. If Amendment, Date of Original Filed (Month/Day/Year)
11/10/2021

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	794,545⁽¹⁾	D

Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4)	2. Date Exercisable and Expiration Date (Month/Day/Year)		3. Title and Amount of Securities Underlying Derivative Security (Instr. 4)		4. Conversion or Exercise Price of Derivative Security	5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5)	6. Nature of Indirect Beneficial Ownership (Instr. 5)
1. Title of Derivative Security (Instr. 4)	Date Exercisable	Expiration Date	Title	Amount or Number of Shares	4. Conversion or Exercise Price of Derivative Security	5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5)	6. Nature of Indirect Beneficial Ownership (Instr. 5)
Convertible Promissory Note	⁽²⁾	⁽²⁾	Common Stock	115,559	⁽²⁾	D
Common Stock warrant (right to buy)	⁽³⁾	02/11/2023	Common Stock	5,818	2.75	D

Explanation of Responses:

1. 32,727 shares are held in the name of his spouse, Marijana Rakic.

2. Represents $485,347.80 of outstanding principal and interest calculated through November 10, 2021. The note will convert into 115,559 shares of Common Stock upon the closing of the Issuer's initial public offering of Common Stock (the "IPO").

3. All of the shares subject to the warrant are fully vested and exercisable as of the date hereof.

Remarks:

This amendment is being filed to correct the number of Derivative Securities Beneficially Owned by Branislav Vajdic on November 10, 2021. The initial filing incorrectly overstated the number of Derivative Securities Beneficially Owned by Branislav Vajdic following the transfer to his ex-wife of 363,636 Common Stock Warrants to purchase shares of common stock of the issuer by 363,636. Consequently, the initial filing overstated the number of Derivative Securities Beneficially Owned by Branislav Vajdic following the transactions subsequently disclosed by the same amount.

	/s/ Branislav Vajdic	10/14/2022
	** 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).
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