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