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