Statement of Changes in Beneficial Ownership (4)
August 02 2021 - 6:10PM
Edgar (US Regulatory)
FORM 4
[X]
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
*
Friar Sarah |
2. Issuer Name and Ticker or Trading Symbol
CCC Intelligent Solutions Holdings Inc.
[
CCCS
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director _____ 10% Owner _____ Officer (give title below) __X__ Other (specify below) Former Director |
(Last)
(First)
(Middle)
ONE LETTERMAN DRIVE, BUILDING D, SUITE M500 |
3. Date of Earliest Transaction
(MM/DD/YYYY)
7/30/2021 |
(Street)
SAN FRANCISCO, CA 94129
(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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Common Stock | 7/30/2021 | 7/30/2021 | C(1) | | 75000 | A | (1) | 75000 | 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 Ordinary Shares | (1) | 7/30/2021 | | C (1) | | | 75000 | (1) | (1) | Common Stock | 75000 | (1) | 0 | D | |
Explanation of Responses: |
(1) | In connection with the completion of the Issuer's initial business combination (the "Business Combination") pursuant to the Business Combination Agreement, as amended, dated February 2, 2021, by and among Dragoneer Growth Opportunities Corp. ("Dragoneer"), Chariot Opportunity Merger Sub, Inc., a wholly owned subsidiary of Dragoneer ("Merger Sub"), and Cypress Holdings, Inc. ("CCC"), the shares of Class B Ordinary Shares automatically converted into shares of Common Stock on a one-for-one basis for no additional consideration. As part of the Business Combination, Dragoneer changed its name to CCC Intelligent Solutions Holdings Inc. (the "Issuer") on July 30, 2021. |
Remarks: This "Exit" Form 4 is voluntarily filed to report that the Reporting Person is no longer serving in the role as the Company's director, effective as of July 30, 2021, and therefore is no longer subject to Section 16 reporting. The Reporting Person did not have any transactions in the Issuer's securities during the time that she was a Section 16 reporting person other than those previously disclosed in Initial Statement of Beneficial Ownership of Securities on Form 3, filed on August 13, 2020. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Friar Sarah ONE LETTERMAN DRIVE, BUILDING D SUITE M500 SAN FRANCISCO, CA 94129 |
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| Former Director |
Signatures
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/s/ Pat Robertson, Attorney-in-Fact Sarah J. Friar | | 8/2/2021 |
**Signature of Reporting Person | Date |
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