0001793659-23-000002.txt : 20230210
0001793659-23-000002.hdr.sgml : 20230210
20230210185218
ACCESSION NUMBER: 0001793659-23-000002
CONFORMED SUBMISSION TYPE: 5
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20221231
FILED AS OF DATE: 20230210
DATE AS OF CHANGE: 20230210
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: BLUHM NEIL
CENTRAL INDEX KEY: 0001373161
FILING VALUES:
FORM TYPE: 5
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39232
FILM NUMBER: 23614057
MAIL ADDRESS:
STREET 1: 900 NORTH MICHIGAN AVENUE
STREET 2: SUITE 1900
CITY: CHICAGO
STATE: IL
ZIP: 60611
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: NGB 2013 GRANDCHILDREN'S DYNASTY TRUST
CENTRAL INDEX KEY: 0001839329
STATE OF INCORPORATION: IL
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 5
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39232
FILM NUMBER: 23614056
BUSINESS ADDRESS:
STREET 1: 900 N. MICHIGAN AVENUE, SUITE 1600
CITY: CHICAGO
STATE: IL
ZIP: 60611
BUSINESS PHONE: (312) 915 1086
MAIL ADDRESS:
STREET 1: 900 N. MICHIGAN AVENUE, SUITE 1600
CITY: CHICAGO
STATE: IL
ZIP: 60611
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Rush Street Interactive, Inc.
CENTRAL INDEX KEY: 0001793659
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MISCELLANEOUS AMUSEMENT & RECREATION [7990]
IRS NUMBER: 000000000
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 900 N. MICHIGAN AVENUE, SUITE 950
CITY: CHICAGO
STATE: IL
ZIP: 60611
BUSINESS PHONE: 773-893-5855
MAIL ADDRESS:
STREET 1: 900 N. MICHIGAN AVENUE, SUITE 950
CITY: CHICAGO
STATE: IL
ZIP: 60611
FORMER COMPANY:
FORMER CONFORMED NAME: dMY Technology Group, Inc.
DATE OF NAME CHANGE: 20191108
5
1
wf-form5_167607311838409.xml
FORM 5
X0306
5
2022-12-31
0
0
0
0001793659
Rush Street Interactive, Inc.
RSI
0001373161
BLUHM NEIL
C/O RUSH STREET INTERACTIVE, INC.
900 N. MICHIGAN AVENUE, SUITE 950
CHICAGO
IL
60611
1
1
1
0
Executive Chairman
0001839329
NGB 2013 GRANDCHILDREN'S DYNASTY TRUST
C/O RUSH STREET INTERACTIVE, INC.
900 N. MICHIGAN AVENUE, SUITE 950
CHICAGO
IL
60611
1
0
1
0
Class V Voting Stock
2022-09-28
5
G
0
10000
0
D
107511780
I
By NGB 2013 Grandchildren's Dynasty Trust
Class V Voting Stock
2022-11-11
5
G
0
100000
0
D
107411780
I
By NGB 2013 Grandchildren's Dynasty Trust
Class V Voting Stock
1362663
I
By Rush Street Interactive GP, LLC
Class V Voting Stock
1527334
I
By NGB 2016 Revocable Trust
Class A Common Units of Rush Street Interactive, L.P.
2022-09-28
5
G
0
10000
0
D
Class A Common Stock
10000.0
107511780
I
By NGB 2013 Grandchildren's Dynasty Trust
Class A Common Units of Rush Street Interactive, L.P.
2022-11-11
5
G
0
100000
0
D
Class A Common Stock
100000.0
107411780
I
By NGB 2013 Grandchildren's Dynasty Trust
Class A Common Units of Rush Street Interactive, L.P.
Class A Common Stock
1362663.0
1362663
I
By Rush Street Interactive GP, LLC
Class A Common Units of Rush Street Interactive, L.P.
Class A Common Stock
1527334.0
1527334
I
By NGB 2016 Revocable Trust
Represents a bona fide charitable gift of the Issuer's Class V Voting Stock from the Reporting Person to a donor-advised fund.
These securities are held by NGB 2013 Grandchildren's Dynasty Trust (the "NGB Dynasty Trust"). The Reporting Person is the grantor and trustee of NGB Dynasty Trust and exercises sole voting and investment control over the securities held thereby. The Reporting Person may be deemed to be the beneficial owner of securities held by the NGB Dynasty Trust to the extent that he or his immediate family members are beneficiaries of such trust.
These securities are held by Rush Street Interactive GP, LLC (the "RSI GP"). The Reporting Person is a manager of RSI GP and exercises sole voting and investment control over, and may be deemed to have an indirect beneficial ownership with respect to, the securities held thereby.
These securities are held by the NGB 2016 Revocable Trust (the "NGB Revocable Trust"). The Reporting Person is the grantor, sole trustee and sole beneficiary of the NGB Revocable Trust.
Pursuant to the Amended and Restated Limited Partnership Agreement of Rush Street Interactive, L.P. ("RSI LP"), beginning on June 29, 2021, the Class A Common Units of RSI LP beneficially owned by the Reporting Person may be exchanged, subject to certain conditions, for one share of Class A Common Stock of the Issuer. Upon such exchange, an equivalent number of shares of Class V Voting Stock then held by the reporting person will be canceled.
Neil Bluhm: /s/ Kyle Sauers as Attorney-in-fact
2023-02-10
NGB 2013 Grandchildren's Dynasty Trust: /s/ Kyle Sauers as Attorney-in-fact
2023-02-10