0001094891-17-000182.txt : 20170815
0001094891-17-000182.hdr.sgml : 20170815
20170815164906
ACCESSION NUMBER: 0001094891-17-000182
CONFORMED SUBMISSION TYPE: 3
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20170815
FILED AS OF DATE: 20170815
DATE AS OF CHANGE: 20170815
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Donaldson Richard C
CENTRAL INDEX KEY: 0001416656
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38186
FILM NUMBER: 171034366
MAIL ADDRESS:
STREET 1: C/O CAPITOL ACQUISITION CORP.
STREET 2: 509 7TH STREET, N.W.
CITY: WASHINGTON
STATE: DC
ZIP: 20004
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Capitol Investment Corp. IV
CENTRAL INDEX KEY: 0001709682
STANDARD INDUSTRIAL CLASSIFICATION: BLANK CHECKS [6770]
IRS NUMBER: 000000000
STATE OF INCORPORATION: E9
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 509 7TH STREET, N.W.
CITY: WASHINGTON
STATE: DC
ZIP: 20004
BUSINESS PHONE: 202-654-7060
MAIL ADDRESS:
STREET 1: 509 7TH STREET, N.W.
CITY: WASHINGTON
STATE: DC
ZIP: 20004
3
1
edgar.xml
PRIMARY DOCUMENT
X0206
3
2017-08-15
0
0001709682
Capitol Investment Corp. IV
CIC
0001416656
Donaldson Richard C
C/O CAPITOL INVESTMENT CORP. IV
509 7TH STREET, N.W.
WASHINGTON
DC
20004
1
0
0
0
Class B ordinary shares
Class A ordinary shares
50000
D
Warrants
11.50
Class A ordinary shares
133333
D
The Class B ordinary shares are convertible for the Issuer's Class A ordinary shares as described under the heading "Description of Securities - Founder Shares" in the Issuer's registration statement on Form S-1 (File No. 333-219146) and have no expiration date.
These warrants will be purchased by Mr. Donaldson simultaneously with the consummation of the IPO.
The warrants will become exercisable on the later of 30 days after the completion of the Issuer's initial business combination or 12 months from the closing of the IPO.
The warrants will expire on the fifth anniversary of the completion of the Issuer's initial business combination.
/s/ Richard C. Donaldson
2017-08-15