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*
Nelli James Patrick Jr.

(Last) (First) (Middle)
C/O HEALTH CATALYST, INC.
3165 MILLROCK DRIVE, #400

(Street)
SALT LAKE CITY UT 84121

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
07/24/2019
3. Issuer Name and Ticker or Trading Symbol
Health Catalyst, Inc. [ HCAT ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Chief Financial Officer
5. 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
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 6,500 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)
Date Exercisable Expiration Date Title Amount or Number of Shares
Stock Option (Right to Buy) (1) 02/10/2025 Common Stock 15,464 $9.24 D
Stock Option (Right to Buy) (2) 10/14/2026 Common Stock 6,500 $10.6 D
Stock Option (Right to Buy) (3) 04/27/2027 Common Stock 15,504 $10.66 D
Stock Option (Right to Buy) (4) 10/26/2027 Common Stock 91,746 $10.72 D
Stock Option (Right to Buy) (5) 09/27/2028 Common Stock 225,000 $10.8 D
Explanation of Responses:
1. 25% of the shares vested on February 10, 2016; and the remaining 75% vest in 36 equal monthly installments thereafter.
2. 25% of the shares vested on October 14, 2017; and the remaining 75% vest in 36 equal monthly installments thereafter.
3. 25% of the shares vested on April 27, 2018; and the remaining 75% vest in 36 equal monthly installments thereafter.
4. 25% of the shares vested on October 26, 2018; and the remaining 75% vest in 36 equal monthly installments thereafter.
5. The stock option vests based on the satisfaction of both a time-based vesting condition and a liquidity-based vesting condition. The time-based vesting condition is satisfied as follows: 25% of the shares subject to the stock option will satisfy the time-based vesting condition on September 25, 2019 and the remaining 75% will satisfy the time-based vesting condition in 36 equal monthly installments thereafter, generally subject to the named executive officer's continuous service relationship with the Company through each applicable vesting date. The liquidity-based vesting condition is satisfied upon the earlier of the Company's initial public offering or a sale of the Company.
Remarks:
Exhibit 24 - Power of Attorney
/s/ Daniel Orenstein, as Attorney-in-Fact 07/24/2019
** 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 Number.