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*
Mortenson Mark

(Last) (First) (Middle)
6550 SOUTH MILLROCK DRIVE
SUITE G50

(Street)
SALT LAKE CITY UT 84121

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
12/30/2020
3. Issuer Name and Ticker or Trading Symbol
Clene Inc. [ CLNN ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Chief Science 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 138,924 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
Incentive Stock Option (right to buy) (1) (1) Common Stock 263,955 2.3754 D
Incentive Stock Option (right to buy) (2) (2) Common Stock 687,604 0.144 D
Explanation of Responses:
1. Awarded under the Clene Nanomedicine, Inc. 2014 Stock Plan on August 26, 2019 and currently exercisable. The options expire 10 years from the date of the grant.
2. Awarded the right to buy 6,210,000 shares of Clene Nanomedicine common stock under the Clene Nanomedicine, Inc. 2014 Stock Plan on July 31, 2014. The reporting party exercised his right to purchase 1,000,000 shares of Clene Nanomedicine common stock on November 23, 2016. Following Clene Nanomedicine, Inc.'s merger, the unexercised options converted into a right to buy common stock of Clene, Inc. The unexercised options now represent the right to buy 687,604 shares of Clene, Inc. common stock. The unexercised options are all currently exercisable and expire 10 years from the date of the grant.
Remarks:
/s/ Jerry Miraglia POA 01/04/2021
** 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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