0000950142-21-000513.txt : 20210211 0000950142-21-000513.hdr.sgml : 20210211 20210211214501 ACCESSION NUMBER: 0000950142-21-000513 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210211 FILED AS OF DATE: 20210211 DATE AS OF CHANGE: 20210211 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: 001-40052 FILM NUMBER: 21622315 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: 001-40052 FILM NUMBER: 21622316 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 VI LLC CENTRAL INDEX KEY: 0001828245 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40052 FILM NUMBER: 21622317 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 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Churchill Capital Corp VI CENTRAL INDEX KEY: 0001828250 STANDARD INDUSTRIAL CLASSIFICATION: BLANK CHECKS [6770] IRS NUMBER: 000000000 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 3 1 es210130380_3-ccvimka.xml OWNERSHIP DOCUMENT X0206 3 2021-02-11 0 0001828250 Churchill Capital Corp VI CCVI 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 0001828245 Churchill Sponsor VI 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 13800000 I See Footnotes The reported shares of Churchill Capital Corp VI (the "Issuer") are directly held by Churchill Sponsor VI LLC and include 1,800,000 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. 333-252005). 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 VI LLC. Chief Executive Officer, President and Chairman of the Board of Directors /s/ Michael Klein 2021-02-11 M. KLEIN ASSOCIATES, INC., Name: Jay Taragin, Title: Authorized Person: /s/ Jay Taragin 2021-02-11 Churchill Sponsor VI LLC, by: M. Klein Associates, Inc., its manager, Name: Jay Taragin, Title: Authorized Person: /s/ Jay Taragin 2021-02-11