0000950142-20-002810.txt : 20201215 0000950142-20-002810.hdr.sgml : 20201215 20201215211947 ACCESSION NUMBER: 0000950142-20-002810 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20201215 FILED AS OF DATE: 20201215 DATE AS OF CHANGE: 20201215 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Klein Michael Stuart CENTRAL INDEX KEY: 0001327392 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39806 FILM NUMBER: 201391165 MAIL ADDRESS: STREET 1: C/O DAVIS POLK & WARDWELL STREET 2: 450 LEXINGTON AVENUE CITY: NEW YORK STATE: NY ZIP: 10017 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: M. Klein Associates, Inc. CENTRAL INDEX KEY: 0001751504 STATE OF INCORPORATION: NY FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39806 FILM NUMBER: 201391166 BUSINESS ADDRESS: STREET 1: 640 FIFTH AVENUE, 12TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10019 BUSINESS PHONE: 212-380-7500 MAIL ADDRESS: STREET 1: 640 FIFTH AVENUE, 12TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10019 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Churchill Sponsor V LLC CENTRAL INDEX KEY: 0001812232 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39806 FILM NUMBER: 201391167 BUSINESS ADDRESS: STREET 1: 640 FIFTH AVENUE, 12TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10019 BUSINESS PHONE: (212) 380-7500 MAIL ADDRESS: STREET 1: 640 FIFTH AVENUE, 12TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10019 FORMER NAME: FORMER CONFORMED NAME: One Judith Sponsor LLC DATE OF NAME CHANGE: 20200514 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Churchill Capital Corp V CENTRAL INDEX KEY: 0001812234 STANDARD INDUSTRIAL CLASSIFICATION: BLANK CHECKS [6770] IRS NUMBER: 851023777 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 640 FIFTH AVENUE, 12TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10019 BUSINESS PHONE: (212) 380-7500 MAIL ADDRESS: STREET 1: 640 FIFTH AVENUE, 12TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10019 FORMER COMPANY: FORMER CONFORMED NAME: One Judith Acquisition Corp DATE OF NAME CHANGE: 20200514 3 1 es200117963_3-ccvmka.xml OWNERSHIP DOCUMENT X0206 3 2020-12-15 0 0001812234 Churchill Capital Corp V CCV 0001327392 Klein Michael Stuart 640 5TH AVENUE, 12TH FLOOR NEW YORK NY 10019 1 1 1 0 See Remarks 0001751504 M. Klein Associates, Inc. 640 FIFTH AVENUE, 12TH FLOOR NEW YORK NY 10019 0 0 1 0 0001812232 Churchill Sponsor V LLC 640 FIFTH AVENUE, 12TH FLOOR NEW YORK NY 10019 0 0 1 0 Class B common stock, par value $0.0001 per share Class A common stock, par value $0.0001 per share 12937500 I See Footnotes The reported shares of Churchill Capital Corp V (the "Issuer") are directly held by Churchill Sponsor V LLC and include 1,687,500 shares of Class B Shares that are subject to forfeiture if the underwriters of the Issuer's initial public offering do not exercise in full an option granted to them to cover over-allotments. Pursuant to the Issuer's Amended and Restated Certificate of Incorporation, the Class B Shares will automatically convert into shares of Class A common stock, par value $0.0001 per share, of the Issuer at the time of the Issuer's initial business combination on a one-for-one basis, subject to adjustment as described under the heading "Description of Securities- Founder Shares" in the Issuer's registration statement on Form S-1 (File No. 333-248972). The shares of Class B common stock have no expiration date. Michael Klein is the controlling stockholder of M. Klein Associates, Inc., which is the managing member of Churchill Sponsor V LLC. Chief Executive Officer, President and Chairman of the Board of Directors /s/ Michael Klein 2020-12-15 M. KLEIN ASSOCIATES, INC., Name: Jay Taragin, Title: Authorized Person: /s/ Jay Taragin 2020-12-15 Churchill Sponsor V LLC, by: M. Klein Associates, Inc., its manager, Name: Jay Taragin, Title: Authorized Person: /s/ Jay Taragin 2020-12-15