Statement of Changes in Beneficial Ownership (4)
December 09 2021 - 6:15PM
Edgar (US Regulatory)
FORM 4
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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
*
Hawks Donald L III |
2. Issuer Name and Ticker or Trading Symbol
SelectQuote, Inc.
[
SLQT
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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 SELECTQUOTE, INC., 6800 WEST 115TH STREET, SUITE 2511 |
3. Date of Earliest Transaction
(MM/DD/YYYY)
12/9/2021 |
(Street)
OVERLAND PARK, KS 66211
(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, par value $0.01 per share | 12/9/2021 | | M | | 4719 | A | $0 | 54719 | D | |
Common Stock, par value $0.01 per share | | | | | | | | 1889285 (1) | I | Owned by SQ Co-investors LLC |
Common Stock, par value $0.01 per share | | | | | | | | 6911600 (1) | I | Owned by BEP III Co-Invest LLC |
Common Stock, par value $0.01 per share | | | | | | | | 8877872 (1) | I | Owned by BEP III LLC |
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 |
Restricted Stock Units (2) | (3) | 12/9/2021 | | M | | | 4719 | (4) | (4) | Common Stock, par value $0.01 per share | 4719.0 | $0 | 0 | D | |
Explanation of Responses: |
(1) | Mr. Hawks owns an indirect pecuniary interest in the securities reported on this line. Mr. Hawks disclaims beneficial ownership of the securities reported on this line except to the extent of his pecuniary interest therein. |
(2) | Represents restricted stock units (RSUs) of SelectQuote, Inc. (the "Company") granted to Mr. Hawks under the Company's 2020 Omnibus Incentive Plan. |
(3) | Each RSU represents a contingent right to receive one share of the Company's common stock, $0.01 par value per share. |
(4) | The RSUs vest in full on the first anniversary of the grant date (the "Vesting Date"), subject to the recipient's continued service on the Company's Board of Directors as of the Vesting Date. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Hawks Donald L III C/O SELECTQUOTE, INC. 6800 WEST 115TH STREET, SUITE 2511 OVERLAND PARK, KS 66211 | X |
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Signatures
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/s/ Daniel A. Boulware, Attorney in Fact | | 12/9/2021 |
**Signature of Reporting Person | Date |
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