0000899243-23-009983.txt : 20230329
0000899243-23-009983.hdr.sgml : 20230329
20230329171953
ACCESSION NUMBER: 0000899243-23-009983
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20230323
FILED AS OF DATE: 20230329
DATE AS OF CHANGE: 20230329
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: SHALEV EDDY
CENTRAL INDEX KEY: 0001255126
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-40048
FILM NUMBER: 23776205
MAIL ADDRESS:
STREET 1: C/O INNOVID, INC.
STREET 2: 30 IRVING PLACE, 12TH FLOOR
CITY: NEW YORK
STATE: NY
ZIP: 10003
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Kishon Eyal
CENTRAL INDEX KEY: 0001899771
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-40048
FILM NUMBER: 23776206
MAIL ADDRESS:
STREET 1: C/O INNOVID, INC.
STREET 2: 30 IRVING PLACE, 12TH FLOOR
CITY: NEW YORK
STATE: NY
ZIP: 10003
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: GENESIS PARTNERS III LP
CENTRAL INDEX KEY: 0001322810
STATE OF INCORPORATION: E9
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-40048
FILM NUMBER: 23776207
BUSINESS ADDRESS:
STREET 1: 11B HAMENOFIM STREET
CITY: HERTZLYIA PITUACH
STATE: L3
ZIP: 4672562
BUSINESS PHONE: 972-9-9729000
MAIL ADDRESS:
STREET 1: POB 12866
CITY: HERTZLYIA PITUACH
STATE: L3
ZIP: 46733
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Innovid Corp.
CENTRAL INDEX KEY: 0001835378
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372]
IRS NUMBER: 000000000
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 30 IRVING PLACE, 12TH FLOOR
CITY: NEW YORK
STATE: NY
ZIP: 10003
BUSINESS PHONE: 2129667555
MAIL ADDRESS:
STREET 1: 30 IRVING PLACE, 12TH FLOOR
CITY: NEW YORK
STATE: NY
ZIP: 10003
FORMER COMPANY:
FORMER CONFORMED NAME: ION Acquisition Corp 2 Ltd.
DATE OF NAME CHANGE: 20201207
4
1
doc4.xml
FORM 4 SUBMISSION
X0407
4
2023-03-23
1
0001835378
Innovid Corp.
CTV
0001322810
GENESIS PARTNERS III LP
13 BASEL ST.
HERZELIYA
L3
4666013
ISRAEL
0
0
1
0
0001899771
Kishon Eyal
13 BASEL ST.
HERZELIYA
L2
IRELAND
0
0
1
0
0001255126
SHALEV EDDY
13 BASEL ST.
HERZELIYA
L2
4666013
IRELAND
0
0
1
0
0
Common Stock
2023-03-23
4
J
0
19350638
D
0
I
See Footnote
Represents a pro rata distribution in-kind by Genesis Partners III L.P. to its partners for no consideration.
Genesis Partners III L.P. is controlled by Eyal Kishon and Eddy Shalev. Kishon and Shalev otherwise disclaim beneficial ownership over the shares beneficially owned by Genesis Partners III L.P.
/s/ Genesis Partners III L.P.
2023-03-29
/s/ Eyal Kishon
2023-03-29
/s/ Eddy Shalev
2023-03-29