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*
Patel Jatin Markand

(Last) (First) (Middle)
2614 BOSTON POST ROAD
SUITE #33B

(Street)
GUILFORD CT 06437

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
04/03/2023
3. Issuer Name and Ticker or Trading Symbol
BioXcel Therapeutics, Inc. [ BTAI ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director X 10% Owner
Officer (give title below) Other (specify below)
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, par value $0.001 per share 8,546,750 I By BioXcel LLC
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
BTAI Aug 18 2023 $25 Put 02/17/2023 08/18/2023 Common Stock, par value $0.001 per share 1,000 25 D
Explanation of Responses:
Remarks:
The Reporting Person may be deemed to share investment control over shares of Common Stock of the Issuer held by BioXcel LLC and held indirectly by BioXcel Holdings, Inc. The reporting person disclaims beneficial ownership of the reported securities except to the extent, if any, of the reporting person's pecuniary interest therein, and this filing shall not be deemed an admission that the Reporting Person is, for purposes of Section 16 of the Securities Exchange Act or otherwise, the beneficial owner of any such shares of Common Stock.
/s/Jatin Patel 04/12/2023
** 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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