Initial Statement of Beneficial Ownership (3)
August 09 2021 - 7:16PM
Edgar (US Regulatory)
FORM 3
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0104
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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
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ADVENT INTERNATIONAL CORP/MA |
2. Date of Event Requiring Statement (MM/DD/YYYY)
7/30/2021
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3. Issuer Name and Ticker or Trading Symbol
CCC Intelligent Solutions Holdings Inc. [CCCS]
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(Last)
(First)
(Middle)
PRUDENTIAL TOWER, 800 BOYLSTON STREET, SUITE 3300 |
4. 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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(Street)
BOSTON, MA 02199
(City)
(State)
(Zip)
| 5. If Amendment, Date Original Filed(MM/DD/YYYY)
| 6. Individual or Joint/Group Filing(Check Applicable Line)
___ Form filed by One Reporting Person
_X_ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Beneficially Owned
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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 | 273339593 (1) | I | See notes (3)(8) |
Common Stock | 8645086 (1) | I | See notes (4)(8) |
Common Stock | 90650165 (1) | I | See notes (5)(8) |
Common Stock | 500000 (2) | I | See notes (6)(8) |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security (Instr. 4) | 2. Date Exercisable and Expiration Date (MM/DD/YYYY) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form of Derivative Security: 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 |
Earnout Shares | (7) | (7) | Common Stock | 7275914 | (7) | I | See notes (3)(8) |
Earnout Shares | (7) | (7) | Common Stock | 230119 | (7) | I | See notes (4)(8) |
Earnout Shares | (7) | (7) | Common Stock | 2412979 | (7) | I | See notes (5)(8) |
Explanation of Responses: |
(1) | See Exhibit 99.1 for text of footnote (1). |
(2) | See Exhibit 99.1 for text of footnote (2). |
(3) | See Exhibit 99.1 for text of footnote (3). |
(4) | See Exhibit 99.1 for text of footnote (4). |
(5) | See Exhibit 99.1 for text of footnote (5). |
(6) | See Exhibit 99.1 for text of footnote (6). |
(7) | See Exhibit 99.1 for text of footnote (7). |
(8) | See Exhibit 99.1 for text of footnote (8). |
Remarks: Effective immediately after the Effective Time, each of Christopher Egan, a Managing Partner of Advent, Eric Wei, a Managing Director of Advent, and Lauren Young, a Managing Director of Advent (collectively, the "Advent Directors"), were appointed to the board of directors of the Issuer, and have been deputized to represent the Reporting Persons on the board of directors. By virtue of the Advent Directors' representation, for purposes of Section 16 of the Securities Exchange Act of 1934, each of the Reporting Persons may be deemed directors by deputization of the Issuer. The Advent Directors have filed separate Section 16 reports disclosing securities of the Issuer that they may be deemed to beneficially own for Section 16 purposes.
Exhibit 99.1 (Footnotes to Form 3) and Exhibit 99.2 (Signatures and Joint Filer Information) are incorporated by reference.
Form 1 of 2: This Form 3 is the first of two Forms 3 being filed relating to the same event. The Form 3 has been split into two filings because there are more than 10 Reporting Persons total, and the SEC's EDGAR filing system limits a single Form 3 to a maximum of 10 Reporting Persons. Each Form 3 will be filed by Designated Filer Advent International Corporation. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
ADVENT INTERNATIONAL CORP/MA PRUDENTIAL TOWER 800 BOYLSTON STREET, SUITE 3300 BOSTON, MA 02199 | X | X |
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Advent International GPE VIII, LLC PRUDENTIAL TOWER 800 BOYLSTON STREET, SUITE 3300 BOSTON, MA 02199 | X | X |
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Advent International GPE VIII-C Limited Partnership PRUDENTIAL TOWER 800 BOYLSTON STREET, SUITE 3300 BOSTON, MA 02199 | X | X |
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GPE VIII CCC Co-Investment (Delaware) Limited Partnership PRUDENTIAL TOWER 800 BOYLSTON STREET, SUITE 3300 BOSTON, MA 02199 | X | X |
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Cypress Investment GP, LLC PRUDENTIAL TOWER 800 BOYLSTON STREET, SUITE 3300 BOSTON, MA 02199 | X | X |
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GPE VIII GP S.a.r.l. PRUDENTIAL TOWER 800 BOYLSTON STREET, SUITE 3300 BOSTON, MA 02199 | X | X |
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GPE VIII GP Limited Partnership PRUDENTIAL TOWER 800 BOYLSTON STREET, SUITE 3300 BOSTON, MA 02199 | X | X |
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Signatures
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ADVENT INTERNATIONAL CORPORATION, By: /s/ Neil Crawford, Title: Director, Fund Administration | | 8/9/2021 |
**Signature of Reporting Person | Date |
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