0000899243-22-005996.txt : 20220211
0000899243-22-005996.hdr.sgml : 20220211
20220211210133
ACCESSION NUMBER: 0000899243-22-005996
CONFORMED SUBMISSION TYPE: 5
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20211231
FILED AS OF DATE: 20220211
DATE AS OF CHANGE: 20220211
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: REY-GIRAUD AGNES
CENTRAL INDEX KEY: 0001235685
FILING VALUES:
FORM TYPE: 5
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39549
FILM NUMBER: 22624166
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: GoodRx Holdings, Inc.
CENTRAL INDEX KEY: 0001809519
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMPUTER PROCESSING & DATA PREPARATION [7374]
IRS NUMBER: 475104396
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 2701 OLYMPIC BOULEVARD
CITY: SANTA MONICA
STATE: CA
ZIP: 90404
BUSINESS PHONE: (855) 268-2822
MAIL ADDRESS:
STREET 1: 2701 OLYMPIC BOULEVARD
CITY: SANTA MONICA
STATE: CA
ZIP: 90404
5
1
doc5.xml
FORM 5 SUBMISSION
X0306
5
2021-12-31
0
0
0
0001809519
GoodRx Holdings, Inc.
GDRX
0001235685
REY-GIRAUD AGNES
2644 30TH ST., STE. 101
SANTA MONICA
CA
90405
1
0
0
0
Class B Common Stock
2021-12-28
5
G
0
28500
0.00
D
Class A Common Stock
28500
226500
I
By ARG Family Legacy Trust #1
Each share of Class B common stock is convertible at any time at the option of the holder into one share of the Issuer's Class A common stock or upon the earliest to occur of (1) the first date on which the aggregate number of outstanding shares of Class B common stock ceases to represent at least 10% of the then-outstanding shares of common stock, (2) the transfer of such share of Class B common stock, other than certain permitted transfers, or (3) September 25, 2027.
Represents shares of Class B common stock donated as a gift. No value was received for the gifted shares.
/s/ Gracye Cheng, as Attorney-in-Fact for Idea Men, LLC
2022-02-11