SEC FORM 3 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*
Slack David W.

(Last) (First) (Middle)
110 ALLEN ROAD
2ND FLOOR

(Street)
BASKING RIDGE NJ 07920

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
09/15/2022
3. Issuer Name and Ticker or Trading Symbol
LISATA THERAPEUTICS, INC. [ LSTA ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
X Officer (give title below) Other (specify below)
President & CBO
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)
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) 03/31/2021(1) 12/03/2029 Common Stock 10,676 4.22 D
Stock Option (Right to Buy) 12/29/2021(2) 12/29/2030 Common Stock 244,213 3.6 D
Explanation of Responses:
1. Twenty-five percent (25%) of the shares issuable upon exercise of the options (the "Option Shares") shall vest on the last day of each three-month period following December 3, 2019 (the "Grant Date"), such that all of the Option Shares shall be vested on the one-year anniversary of the Grant Date.
2. Twenty-five percent (25%) of the Option Shares will be vested and exercisable upon the one (1) year anniversary of December 29, 2020 (the "Grant Date"); and the remaining Option Shares will vest and become exercisable in a series of thirty-six (36) successive equal monthly installments, rounded downward to the nearest whole share, measured from the first (1st) anniversary of the Grant Date, such that 100% of the Option Shares will be vested and exercisable upon the fourth (4th) anniversary of the Grant Date.
Remarks:
Exhibit List: Exhibit 24, Power of Attorney
James Nisco, Attorney-in-fact for David Slack 09/16/2022
** 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).
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.
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POWER OF ATTORN[\ ..:.nm\ all b) thc:-c prc,cnt, that the unJcr-,igned hcrcb~ COl1'titutcs um.I J)'points cuch ol' OJ\ id J. Mano. fame!> :-,iiM:o and Am~ .lacbon A~ .,la ,,fCaladriu.., Aioc;cicncc!>. Inc. (the .. Compan) .. ). and kffrc} P. Schulu and Jod Papcmil of MintL. Lc\'in. Cohn. 1·cms. Glm ,I.) and P11pco, l'.C .. ,i!c!ning sing I~. ,, 1th lull fKl" er of ,ub'.>tit11tion. the 1J1Hkr<.ignl·d ·, rruc and Iii\\ ful attornc> •in-fact to: l) c\ccuh: nnd deli\!cr for and on bchul r of the undc~ig.111:J. foml'> and auth\.'ntication documcni-. for l D<. iAR Filing t\<:~s; 2) do and pcrfonn un) and .111 ac1' for anJ un hchal r of the urHlcr~i£nC'd \\ hkh ma~ he ncccs!l:t': or <lc~ir:,hlc to complete .ind c,ccutc an~ ,uch fonm and authcntkmion documents: 3) c~t.-cutc and ddivcr for and on bchalfof die 1mtler~igncd. in th.: undcr~igned'~ capacit> as an otlic4.!r. director and/or I0° o shareholder of the Com pan). Fonn~ :-. .i and ~ in accordance with Sett ion I 6(:1) of the Sccuritic" r:whan~c Acl of I t)}-t and thl.' rule, thl.'rcundcr . .J) Jo :md pcrfonn an) and all .,cir, for and on behalf of 1hc undersigned whid1 nH1) he nccc~~m, t•r Jl.'sir:ihlc tn complete .ind execute an~ ~ui:h I unn 3 . .J or 5 :md timcl) lilc ~uch fonn \\ ith lhc I nitcd ~talc~ Securitic:, and I·. ,than~c Commission .ind :my stoi:k csd,angc. self-rcgulu1ory or simil3r au1horit): and 5) talc uny other action of an) t) pc \\.lum,oi.:vcr in connection \\ irh the foregoing which. in the l1pi11io11 of !-lll.'h ouomcy-in•fact. may be of bcncfil IO. in the hcs1 interest ot: 11r k!,!..illy rl'quirl.'d h~ the undcrs,gncu. it hdng umkr<-1ood thal the document ~ l"\l'Cutcd b) ,udl nl\urrw~ -in-fact 011 he halt' of the undcr~ii,:ncd plll ,uant to lhi, P,1\\Cr of ,\ttoOIC) ~h.111 he in ,11ch fonn and ,hull cont:lin ,uch tcnn, and conditions a, ~uch :1uomc>-in-fac1 um~ appro\c in .. uch ;1uomey-in-tiu:1\ dbcn:1ion. The undersigned hcrch~ grun1s to each such allornc}·in•fact full power and authurit~ to <11., and perform :in)' and e\C~ ,tel and rhin).! "lunsoc, er rc1.1uisitc. necess,11). or prorcr 111 hi! dom• in tlic ,:.l(c:rcise of tlll} of th,: righ1s und Jl{l\\ er::. herein grantc.-d. a, full) 10 all in1cnt!> and purpo!l.c, a, the undcr,i~ncd mi!,!hl or could do it'per,cmnll) prc ... c111. wi1h full pcm er of suh-;tilution or n.•\ ocation, hcrcb~ ratil~ ing ;md Cl1nfinnin~ all that ~uch allomc~ -in-fort. or ~111:h allomcy· in-fact's !,ub,tirntc <ir suh~litulc'>. ,t,all l,m fully do <lr CalN' tu he done b) \'ir1uc of thi~ Po\\cr of Allorne} .mu the ri_ghb anu p<1,, er hcrcin l!ra111ed. The undcr..igncd oclml\\ lcdltc~ lhill the foregoing attome} !,.-in.fact. m sen ing in c,uo.;h cap:icit~ at the rc'4w,t of the undcr<;igncc.J. arc nut U!l.!>uminl?, nor i!, lhc C.'mnpan> a.,suminl!. (i) an~ of the undcr-.igncd\ n:,pon!.ihilitil.'~ hl compl) ,,ith the requirements of rhc E:o..changc .'\ct or an) linhilit} for lhc u11tkr-.igm:d ·., failure lo com pl> "ith \llCh rc4uin:mcn1,; or (ii) :my ohligmion or liahilit)· that the undcr!\igned incur,. for profit di,gort1cmcn1 under Section 16(h) of the Sccuritil'!> 1..,changc Act of 1934. as am~'f1Jcd. l"hi!> Power of Attornc} shall remain in full force and cflcct until the undcr<;i~ncJ is no longc:r rl~quircd 10 tile l·onm, 3, 4 unu 5 n i1h rc~pcct to the undersigned'~ hol<linl!~ of unJ 1r:m~11ctiom, in ,ccuriric, isi;ucd h~ clic Company. unk,, c.irlier rcH1led by the unllcr!lignl'J in a signcll \\riling l.leli\'crcd lO the lcm:goint attnmc~,·tn·lact. l"hi!- Po\\ er of :\ttornc~ doc=.-. nt11 rl'\ okc an~ other flO" er of unorncy that the undersigned har, pre\· iow,I) ~mntcd. 111.J \\ 111\[SS \VI II.IU-01'. the 11111.lersi~ncd ha-. '"au,co 1hi!. P,1,\cr of Attomc) to he cxc~ulc:d 1hb I<>'" day nf Aui:ust 202:?. . J ~ /;~/ ~ :::::::<:: Signature David W, Slack Print r-:ume