Initial Statement of Beneficial Ownership (3)
June 10 2022 - 4:14PM
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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Fisher Stephanie D. |
2. Date of Event Requiring Statement (MM/DD/YYYY)
6/1/2022
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3. Issuer Name and Ticker or Trading Symbol
SelectQuote, Inc. [SLQT]
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(Last)
(First)
(Middle)
C/O SELECTQUOTE, INC., 6800 WEST 115TH STREET, SUITE 2511 |
4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
_____ Director _____ 10% Owner ___X___ Officer (give title below) _____ Other (specify below) Chief Accounting Officer / |
(Street)
OVERLAND PARK, KS 66211
(City)
(State)
(Zip)
| 5. If Amendment, Date Original Filed(MM/DD/YYYY)
| 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 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, par value $0.01 per share | 1659 | 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. 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 |
Restricted Stock Units (1) | (2) | 8/1/2031 | Common Stock, par value $0.01 per share | 4850.0 | $0.0 | D | |
Restricted Stock Units (1) | (2) | 8/3/2030 | Common Stock, par value $0.01 per share | 1975.0 | $0.0 | D | |
Employee Stock Options (3) | (4) | 8/1/2031 | Common Stock, par value $0.01 per share | 9556.0 | $17.8 | D | |
Employee Stock Options (3) | (4) | 8/3/2030 | Common Stock, par value $0.01 per share | 5188.0 | $19.03 | D | |
Employee Stock Options (3) | (4) | 3/10/2032 | Common Stock, par value $0.01 per share | 23501.0 | $2.51 | D | |
Explanation of Responses: |
(1) | Represents restricted stock units of SelectQuote, Inc. (the "Company") granted to Ms. Fisher pursuant to the Company's 2020 Omnibus Incentive Plan (the "Plan"). Each RSU represents a contingent right to receive one share of the Company's common stock, par value $0.01 per share. |
(2) | The RSUs vest ratably in four annual installments commencing on the one-year anniversary of the grant date, subject to the reporting person's continued employment with the Company as of the applicable vesting date. |
(3) | Represents non-qualified stock options of the Company granted to Ms. Fisher pursuant to the Plan. |
(4) | The option vests ratably in four annual installments commencing on the one-year anniversary of the grant date, subject to the reporting person's continued employment with the Company as of the applicable vesting date. |
Remarks: Exhibit 24 - Power of Attorney |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Fisher Stephanie D. C/O SELECTQUOTE, INC. 6800 WEST 115TH STREET, SUITE 2511 OVERLAND PARK, KS 66211 |
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| Chief Accounting Officer |
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Signatures
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/s/ Daniel A. Boulware, Attorney-in-Fact | | 6/10/2022 |
**Signature of Reporting Person | Date |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. |
* | If the form is filed by more than one reporting person, see Instruction 5(b)(v). |
** | Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
Note: | File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. |
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. |
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