Statement of Changes in Beneficial Ownership (4)
September 21 2020 - 07:11PM
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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3235-0287
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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
*
Gores Sponsor V LLC |
2. Issuer Name and Ticker or Trading Symbol
Gores Holdings V Inc.
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GRSV
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director __X__ 10% Owner _____ Officer (give title below) _____ Other (specify below)
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(Last)
(First)
(Middle)
C/O GORES HOLDINGS V, INC., 9800 WILSHIRE BLVD. |
3. Date of Earliest Transaction
(MM/DD/YYYY)
9/21/2020 |
(Street)
BEVERLY HILLS, CA 90212
(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)
___ Form filed by One Reporting Person
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X
_ 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 F Common Stock, par value $0.0001 per share | (1) | 9/21/2020 | | D (2) | | | 531250 | (1) | (1) | Class A Common Stock | 531250 | $0.00 | 13050000 | D (3)(4)(5) | |
Explanation of Responses: |
(1) | Pursuant to the Amended and Restated Certificate of Incorporation of Gores Holdings V, Inc. (the "Issuer"), shares of Class F common stock, par value $0.0001 per share (the "Class F Shares") have no expiration date and (i) are convertible into shares of Class A common stock, par value $0.0001 per share ("Class A Shares"), of the Issuer at any time at the option of the holder on a one-for-one basis and (ii) will automatically convert into Class A Shares at the time of the Issuer's initial business combination on a one-for-one basis, in each case, subject to adjustment as described under the heading "Description of Securities-Founder Shares" in the Issuer's registration statement on Form S-1 (File No. 333-239962). The Class F Shares are held directly by Gores Sponsor V LLC (the "Sponsor"). |
(2) | The Sponsor forfeited 531,250 Class F Shares to the Issuer for no consideration, which was exempted pursuant to Rule 16b-3(e), in connection with the underwriter's election not to exercise the remaining unused portion of the over-allotment option. |
(3) | The managing member of the Sponsor is AEG Holdings, LLC ("AEG"). Alec Gores is the managing member of AEG (and together with the Sponsor and AEG, the "Reporting Persons"). |
(4) | Because of the relationship among the Reporting Persons, the Reporting Persons may be deemed to beneficially own the securities reported herein to the extent of their respective pecuniary interests. Each Reporting Person disclaims beneficial ownership of the securities reported herein, except to the extent of such Reporting Person's pecuniary interest therein, if any. |
(5) | Pursuant to Rule 16a-1(a)(4) under the Exchange Act, this filing shall not be deemed an admission that the Reporting Persons are, for purposes of Section 16 of the Exchange Act or otherwise, the beneficial owners of any equity securities in excess of their respective pecuniary interests. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Gores Sponsor V LLC C/O GORES HOLDINGS V, INC. 9800 WILSHIRE BLVD. BEVERLY HILLS, CA 90212 | X | X |
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AEG Holdings, LLC 9800 WILSHIRE BLVD. BEVERLY HILLS, CA 90212 | X | X |
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Gores Alec E 9800 WILSHIRE BLVD. BEVERLY HILLS, CA 90212 | X | X |
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Signatures
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By: /s/ Andrew McBride, Attorney-in-Fact for Gores Sponsor V LLC | | 9/21/2020 |
**Signature of Reporting Person | Date |
By: /s/ Andrew McBride, Attorney-in-Fact for AEG Holdings, LLC | | 9/21/2020 |
**Signature of Reporting Person | Date |
By: /s/ Andrew McBride, Attorney-in-Fact for Alec Gores | | 9/21/2020 |
**Signature of Reporting Person | Date |
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