Statement of Changes in Beneficial Ownership (4)
December 09 2019 - 4:56PM
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
*
Wilczek Mira |
2. Issuer Name and Ticker or Trading Symbol
EverQuote, Inc.
[
EVER
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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 EVERQUOTE, INC., 210 BROADWAY |
3. Date of Earliest Transaction
(MM/DD/YYYY)
12/5/2019 |
(Street)
CAMBRIDGE, MA 02139
(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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Class A Common Stock | 12/5/2019 | | J(1) | | 90897 (1) | A | $0.00 | 90897 | D | |
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 | (2) | | | | | | | (2) | (2) | Class A Common Stock | (2) | | 0 | I | See footnote (3) |
Explanation of Responses: |
(1) | On December 5, 2019, Link Ventures Investment Vehicle II, LLC transferred 90,897 shares of Class B Common Stock to Mira Wilczek in connection with her position as a partner of Link Ventures. Pursuant to the issuer's Restated Certificate of Incorporation, the shares automatically converted to Class A Common Stock on a one-to-one basis upon transfer. |
(2) | The Class B Common Stock is convertible into the issuer's Class A Common Stock on a one-for-one basis upon certain transfers of such shares and at the holder's election and has no expiration date. |
(3) | Consists of shares held by Cogo Labs, Inc., with respect to which Cogo Labs, Inc. had empowered Mira Wilczek and Seth Birnbaum, acting together and not individually, to exercise investment power, which was revoked by Cogo Labs, Inc. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Wilczek Mira C/O EVERQUOTE, INC. 210 BROADWAY CAMBRIDGE, MA 02139 | X |
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Signatures
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/s/ David Mason, as attorney-in-fact for Mira Wilczek | | 12/6/2019 |
**Signature of Reporting Person | Date |
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