Statement of Changes in Beneficial Ownership (4)
July 31 2020 - 5:14PM
Edgar (US Regulatory)
FORM 4
[ ]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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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
*
Sherman Jonathan D |
2. Issuer Name and Ticker or Trading Symbol
Collective Growth Corp
[
CGRO
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director _____ 10% Owner _____ Officer (give title below) _____ Other (specify below)
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(Last)
(First)
(Middle)
C/O COLLECTIVE GROWTH CORPORATION, 1805 WEST AVENUE |
3. Date of Earliest Transaction
(MM/DD/YYYY)
6/29/2020 |
(Street)
AUSTIN, TX 78701
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
_X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security (Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code (Instr. 8)
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4. Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Trans. Date | 3A. Deemed Execution Date, if any | 4. Trans. Code (Instr. 8) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) | 6. Date Exercisable and Expiration Date | 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) | 8. Price of Derivative Security (Instr. 5) | 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) | 10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) |
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Class B Common Stock | (1) | 6/29/2020 | | D | | | 4922 | (1) | (1) | Class A Common Stock | 4922 | $0 (2) | 32813 | D | |
Class B Common Stock | (1) | 6/29/2020 | | D | | | 24937 | (1) | (1) | Class A Common Stock | 24937 | $0 (2) | 166250 | I | By 2702933 Ontario Inc. (3) |
Class B Common Stock | (1) | 7/29/2020 | | P | | 10000 | | (1) | (1) | Class A Common Stock | 10000 | $.0001 | 176250 | I | By 2702933 Ontario Inc. (3) |
Explanation of Responses: |
(1) | The shares of Class B common stock will automatically convert into shares of Class A common stock at the time of the Issuer's initial business combination on a one-for-one basis, subject to adjustment. The Class B common stock has no expiration date. |
(2) | The shares were forfeited for no consideration in connection with the underwriters' election not to exercise the over-allotment option as described in the Issuer's registration statement on Form S-1. |
(3) | 2702933 Ontario Inc. is an entity controlled by the reporting person. The reporting person disclaims beneficial ownership of the shares held by 2702933 Ontario Inc. except to the extent of his pecuniary interest therein. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Sherman Jonathan D C/O COLLECTIVE GROWTH CORPORATION 1805 WEST AVENUE AUSTIN, TX 78701 | X |
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Signatures
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/s/ Jonathan D. Sherman | | 7/31/2020 |
**Signature of Reporting Person | Date |
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