Insider filing report for Changes in Beneficial Ownership
- Schedule 13G & 13D forms are used to report a party's ownership of stock which exceeds 5% of a company's total stock issue.
- Schedule 13G is a shorter version of Schedule 13D with fewer reporting requirements.
- Peter Lynch
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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
SCHEDULE 13G
Under the Securities Exchange Act of 1934
(Amendment No. )*
HEART TEST LABORATORIES, INC.
(Name of Issuer)
Common Stock, par value $0.001 per share
(Title of Class of Securities)
42254E104
(CUSIP Number)
December 31, 2022
(Date of Event Which Requires Filing of this Statement)
Check the appropriate box to designate the rule pursuant to which this Schedule is filed:
☐ Rule 13d-1(b)
☐ Rule 13d-1(c)
☒ Rule 13d-1(d)
* The remainder of this cover page shall be filled out for a reporting person's initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter the disclosures provided in a prior cover page.
The information required in the remainder of this cover page shall not be deemed to be “filed” for the purpose of Section 18 of the Securities Exchange Act of 1934 (“Act”) or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however, see the Notes).
SCHEDULE 13G
CUSIP No. |
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Page 2 of NUMPAGES \* MERGEFORMAT 2 |
CUSIP No. 42254E104
(1) |
Names of reporting persons Mark Hilz
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(2) |
Check the appropriate box if a member of a group (see instructions)
(a) ☐ (b) ☐ |
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(3) |
SEC use only
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(4) |
Citizenship or place of organization United States
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Number of |
(5) |
Sole voting power 580,502
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shares beneficially owned by |
(6) |
Shared voting power 0
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each reporting person |
(7) |
Sole dispositive power 580,502
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with: |
(8) |
Shared dispositive power 0
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(9) |
Aggregate amount beneficially owned by each reporting person 580,502
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(10) |
Check if the aggregate amount in Row (9) excludes certain shares (see instructions)
☐ |
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(11) |
Percent of class represented by amount in Row (9) 5.9%
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(12) |
Type of reporting person (see instructions)
IN |
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SCHEDULE 13G
CUSIP No. |
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Page 3 of NUMPAGES \* MERGEFORMAT 2 |
Item 1. |
(a) Name of Issuer: Heart Test Laboratories, Inc. (b) Address of Issuer’s Principal Executive Offices: 550 Reserve St, Suite 360 |
Item 2. |
(a) Name of Person Filing Mark Hilz (b) Address of principal business office or, if none, residence: c/o Heart Test Laboratories, Inc. (c) Citizenship: United States (d) Title of Class of Securities: Common Stock, par value $0.001 per share (e) CUSIP Number: 42254E104 |
Item 3. |
If this statement is filed pursuant to §§240.13d-1(b) or 240.13d-2(b) or (c), check whether the person filing is a: Not Applicable |
Item 4. |
Ownership. Provide the following information regarding the aggregate number and percentage of the class of securities of the issuer identified in Item 1. (a) Amount beneficially owned: 580,502 (b) Percent of class: 5.9% (c) Number of shares as to which the person has: (i) Sole power to vote or to direct the vote 580,502 (ii) Shared power to vote or to direct the vote 0 |
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(iii) Sole power to dispose or to direct the disposition of 580,502 (iv) Shared power to dispose or to direct the disposition of 0 |
Item 5. |
Ownership of Five Percent or Less of a Class. Not Applicable |
Item 6. |
Ownership of More than Five Percent on Behalf of Another Person. Not Applicable |
Item 7. |
Identification and Classification of the Subsidiary Which Acquired the Security Being Reported on by the Parent Holding Company or Control Person. Not Applicable |
Item 8. |
Identification and Classification of Members of the Group. Not Applicable |
Item 9. |
Notice of Dissolution of Group. Not Applicable |
Item 10. |
Certifications. Not Applicable |
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SCHEDULE 13G
CUSIP No. |
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Page 5 of NUMPAGES \* MERGEFORMAT 2 |
SIGNATURE
After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct.
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March 10, 2023 |
Date |
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/s/ Andrew Simpson |
Andrew Simpson |