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*
HALPERN JOHN D

(Last) (First) (Middle)
PO BOX 540

(Street)
PORTSMOUTH NH 03802

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
12/27/2023
3. Issuer Name and Ticker or Trading Symbol
Comera Life Sciences Holdings, Inc. [ CMRA ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
Officer (give title below) X Other (specify below)
Member of 10% owner group
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
Form filed by One Reporting Person
X 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 1,088,819 I By Trust(1)
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
Warrants to Purchase Common Stock 01/02/2023 01/02/2028 Common Stock 405,404 1.23 I By Trust(1)
Warrants to Purchase Common Stock 02/01/2024 07/31/2028 Common Stock 855,745 0.6135 I By Trust(1)
Warrants to Purchase Common Stock 09/11/2023 09/11/2028 Common Stock 366,748 0.6135 I By Trust(1)
Warrants to Purchase Common Stock 12/29/2023 12/29/2028 Common Stock 4,073,744 0.055 I By Trust(1)
12.0% Senior Secured Convertible Notes 12/29/2023 12/29/2024 Common Stock 2,036,872 0.055 I By Trust(1)
1. Name and Address of Reporting Person*
HALPERN JOHN D

(Last) (First) (Middle)
PO BOX 540

(Street)
PORTSMOUTH NH 03802

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Halpern Katherine H.

(Last) (First) (Middle)
P.O. BOX 540

(Street)
PORTSMOUTH NH 03802

(City) (State) (Zip)
Explanation of Responses:
1. Held by John D. Halpern Revocable Trust, of which both John D. Halpern and Katherine H. Halpern are trustees.
/s/ John D. Halpern 01/08/2024
/s/ Katherine H. Halpern 01/08/2024
** 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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