Initial Statement of Beneficial Ownership (3)
April 23 2021 - 6:36PM
Edgar (US Regulatory)
FORM 3
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0104
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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
*
Srinivasan Sudarsan |
2. Date of Event Requiring Statement (MM/DD/YYYY)
4/12/2021
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3. Issuer Name and Ticker or Trading Symbol
Atomera Inc [ATOM]
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(Last)
(First)
(Middle)
750 UNIVERSITY AVENUE, SUITE 280 |
4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
_____ Director _____ 10% Owner
___X___ Officer (give title below) _____ Other (specify below)
VP Engineering / |
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(Street)
LOS GATOS, CA 95032
(City)
(State)
(Zip)
| 5. If Amendment, Date Original Filed(MM/DD/YYYY)
| 6. Individual or Joint/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 Beneficially Owned
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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)
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1. Title of Derivate Security
(Instr. 4) | 2. Date Exercisable and Expiration Date
(MM/DD/YYYY) | 3. Title and Amount of Securities Underlying Derivative Security
(Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form of Derivative Security: 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) | 4/12/2031 | Common Stock | 38000 | $23.75 | D | |
| Explanation of Responses: |
| (1) | Each Option shall vest and first become exercisable as follows: one quarter of the Option shall vest and first become exercisable on April 12, 2022 and the remainder of the Option shall vest and become exercisable in 12 equal quarterly installments commencing on July 12, 2022. |
Reporting Owners
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| Reporting Owner Name / Address | Relationships |
| Director | 10% Owner | Officer | Other |
Srinivasan Sudarsan
750 UNIVERSITY AVENUE, SUITE 280
LOS GATOS, CA 95032 |
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| VP Engineering |
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Signatures
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| /s/ Sudarsan Srinivasan | | 4/23/2021 |
| **Signature of Reporting Person | Date |
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