# EDGAR Filing Document

**Accession Number:** 0001814114
**File Stem:** 0001213900-23-006176
**Filing Date:** 2023-1
**Character Count:** 9931
**Document Hash:** b2fc50b39a935d04d6b0f932832baa7a
**Contains OCR:** False
**Source Format:** 

## Filing Content

## Filing Summary
**0001213900-23-006176.hdr.sgml**: 20230130

**ACCESSION NUMBER**: 0001213900-23-006176

**CONFORMED SUBMISSION TYPE**: 4

**PUBLIC DOCUMENT COUNT**: 1

**CONFORMED PERIOD OF REPORT**: 20230126

**FILED AS OF DATE**: 20230130

**DATE AS OF CHANGE**: 20230130

**REPORTING-OWNER**: 

**OWNER DATA:**
- **COMPANY CONFORMED NAME:** Sherman Darren
- **CENTRAL INDEX KEY:** 0001723524

**FILING VALUES:**
- **FORM TYPE:** 4
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 001-39421
- **FILM NUMBER:** 23570022

**MAIL ADDRESS:**
- **STREET 1:** C/O MOTUS GI HOLDINGS, INC.
- **STREET 2:** 1301 EAST BROWARD BLVD, 3RD FLOOR
- **CITY:** FT. LAUDERDALE
- **STATE:** FL
- **ZIP:** 33301
**ISSUER**: 

**COMPANY DATA:**
- **COMPANY CONFORMED NAME:** Orchestra BioMed Holdings, Inc.
- **CENTRAL INDEX KEY:** 0001814114
- **STANDARD INDUSTRIAL CLASSIFICATION:** SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841]
- **IRS NUMBER:** 000000000
- **STATE OF INCORPORATION:** DE
- **FISCAL YEAR END:** 1231

**BUSINESS ADDRESS:**
- **STREET 1:** 150 UNION SQUARE DRIVE
- **CITY:** NEW HOPE
- **STATE:** PA
- **ZIP:** 18938
- **BUSINESS PHONE:** 646-343-9298

**MAIL ADDRESS:**
- **STREET 1:** 150 UNION SQUARE DRIVE
- **CITY:** NEW HOPE
- **STATE:** PA
- **ZIP:** 18938

**FORMER COMPANY:**
- **FORMER CONFORMED NAME:** Health Sciences Acquisitions Corp 2
- **DATE OF NAME CHANGE:** 20200603

### UNITED STATES SECURITIES AND EXCHANGE COMMISSION
**Washington, D.C. 20549**

## FORM 4

### STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

[ ] Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).

[ ] Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan for the purchase or sale of equity securities of the issuer that is intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10.

---

| | | |
|:---|:---|:---|
| **1. Name and Address of Reporting Person**<sup>*</sup><br>Sherman Darren<br><sub>(Last) (First) (Middle)</sub><br>C/O ORCHESTRA BIOMED HOLDINGS, INC.<br>150 UNION SQUARE DRIVE<br><sub>(Street)</sub><br>NEW HOPE, PA 18938<br><sub>(City) (State) (Zip)</sub> | **3. Date of Earliest Transaction (Month/Day/Year)**<br>2023-01-26 | **5. Relationship of Reporting Person(s) to Issuer**<br>(Check all applicable)<br>[X] Director [ ] 10% Owner<br>[X] Officer (give title below) [ ] Other (specify below)<br>_See Remarks_ |
| **2. Issuer Name and Ticker or Trading Symbol**<br>Orchestra BioMed Holdings, Inc. [ OBIO ] | **4. If Amendment, Date of Original Filed (Month/Day/Year)**<br>  | **6. Individual or Joint/Group Filing (Check Applicable Line)**<br>[X] Form filed by One Reporting Person<br>[ ] Form filed by More than One Reporting Person |

---

## Table I - Non-Derivative Securities

---

|  |  |  |  |  |  |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| 1. Title of Security | 2. Transaction Date | 2A. Deemed Execution Date | 3. Transaction Code (V) | 3. Transaction Code (V) | 4. Securities Acquired (A) or Disposed of (D) | 4. Securities Acquired (A) or Disposed of (D) | 4. Securities Acquired (A) or Disposed of (D) | 5. Amount of Securities Beneficially Owned | 6. Ownership Form | 7. Nature of Indirect Beneficial Ownership |
| 1. Title of Security | 2. Transaction Date | 2A. Deemed Execution Date | Code | V | Amount | (A) or (D) | Price | 5. Amount of Securities Beneficially Owned | 6. Ownership Form | 7. Nature of Indirect Beneficial Ownership |
| Common Stock, par value $0.0001 per share ("Common Stock") | 2023-01-26 |  | A |  | 68189<sup>(1)</sup> | A | <sup>(2)</sup> | 68189 | D |  |

---

## Table II - Derivative Securities

---

|  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| 1. Title of Derivative Security | 2. Conversion or Exercise Price | 3. Transaction Date | 3A. Deemed Execution Date | 4. Transaction Code (V) | 4. Transaction Code (V) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) | 6. Date Exercisable and Expiration Date | 6. Date Exercisable and Expiration Date | 7. Title and Amount of Underlying Securities | 7. Title and Amount of Underlying Securities | 8. Price of Derivative Security | 9. Number of Derivative Securities Beneficially Owned | 10. Ownership Form | 11. Nature of Indirect Beneficial Ownership |
| 1. Title of Derivative Security | 2. Conversion or Exercise Price | 3. Transaction Date | 3A. Deemed Execution Date | Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | 8. Price of Derivative Security | 9. Number of Derivative Securities Beneficially Owned | 10. Ownership Form | 11. Nature of Indirect Beneficial Ownership |
| Nonstatutory Stock Option (Right to Buy) | $4.30 | 2023-01-26 |  | A |  | 310321 |  | 2023-01-26 | 2028-08-07 | Common Stock | 310321 | <sup>(3)</sup> | 310321 | D |  |
| Nonstatutory Stock Option (Right to Buy) | $4.30 | 2023-01-26 |  | A |  | 46500 |  | <sup>(4)</sup> | 2032-04-11 | Common Stock | 46500 | <sup>(5)</sup> | 46500 | D |  |
| Nonstatutory Stock Option (Right to Buy) | $10.00 | 2023-01-26 |  | A |  | 508397 |  | <sup>(6)</sup> | 2023-08-07 | Common Stock | 508397 | <sup>(7)</sup> | 508397 | D |  |
| Nonstatutory Stock Option (Right to Buy) | $10.00 | 2023-01-26 |  | A |  | 116250 |  | <sup>(8)</sup> | 2023-01-19 | Common Stock | 116250 | <sup>(9)</sup> | 116250 | D |  |
| Incentive Stock Option (Right to Buy) | $4.06 | 2023-01-26 |  | A |  | 6743 |  | <sup>(10)</sup> | 2032-04-11 | Common Stock | 6743 | <sup>(11)</sup> | 6743 | D |  |

---

### Footnotes:

(1) These securities were issued on the closing date of the merger (the "Business Combination") contemplated by the Agreement and Plan of Merger, dated as of July 4, 2022, as amended by Amendment No. 1 thereto dated as of July 21, 2022 and Amendment No. 2 thereto dated as of November 21, 2022 (as amended, the "Merger Agreement"), by and among Orchestra BioMed Holdings, Inc. (f/k/a Health Sciences Acquisitions Corporation 2) ("HSAC2"), HSAC Olympus Merger Sub, Inc., a Delaware corporation and wholly owned subsidiary of HSAC2, and Orchestra BioMed, Inc., a Delaware corporation ("Legacy Orchestra"), in exchange for Legacy Orchestra securities.

(2) Received in the Business Combination in exchange for 147,998 shares of common stock of Legacy Orchestra ("Legacy Orchestra Common Stock").

(3) Received in the Business Combination in exchange for a nonstatutory stock option to acquire 667,357 shares of Legacy Orchestra Common Stock for $2.00 per share.

(4) The nonstatutory stock options ("NSOs") vest over a three-year period as follows: (i) 33% of the underlying shares vested on the grant date and (ii) 67% of the underlying shares have vested and will vest in equal installments on a quarterly basis on the last day of each quarter, starting with the end of the first quarter after the grant date, subject to the Reporting Person's continuous service through such dates. The grant date is April 12, 2022.

(5) Received in the Business Combination in exchange for a nonstatutory stock option to acquire 100,000 shares of Legacy Orchestra Common Stock for $2.00 per share.

(6) The NSOs vest over a three-year period as follows: (i) 33% of the underlying shares vested on the grant date and (ii) 67% of the underlying shares have vested and will vest in equal installments on a quarterly basis on the last day of each quarter, starting with the end of the first quarter after the grant date, subject to the Reporting Person's continuous service through such dates. The grant date is August 18, 2022.

(7) Received in the Business Combination in exchange for a nonstatutory stock option to acquire 1,093,327 shares of Legacy Orchestra Common Stock for $4.65 per share.

(8) The NSOs vest over a three-year period as follows: (i) 33% of the underlying shares vested on the grant date and (ii) 67% of the underlying shares have vested and will vest in equal installments on a quarterly basis on the last day of each quarter, starting with the end of the first quarter after the grant date, subject to the Reporting Person's continuous service through such dates. The grant date is January 20, 2023.

(9) Received in the Business Combination in exchange for a nonstatutory stock option to acquire 250,000 shares of Legacy Orchestra Common Stock for $4.65 per share.

(10) The incentive stock options vest over a three-year period as follows: (i) 33% of the underlying shares vested on the grant date and (ii) 67% of the underlying shares have vested and will vest in equal installments on a quarterly basis on the last day of each quarter, starting with the end of the first quarter after the grant date, subject to the Reporting Person's continuous service through such dates. The grant date is April 12, 2022.

(11) Received in the Business Combination in exchange for an incentive stock option to acquire 14,500 shares of Legacy Orchestra Common Stock for $1.89 per share.

**Signature:** /s/ Matthew R. Schob, as Attorney-in-Fact  
**Date:** 2023-01-30

### Remarks:

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 4 (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.**