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