0001213900-21-034839.txt : 20210629
0001213900-21-034839.hdr.sgml : 20210629
20210629202018
ACCESSION NUMBER: 0001213900-21-034839
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210625
FILED AS OF DATE: 20210629
DATE AS OF CHANGE: 20210629
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Boris David
CENTRAL INDEX KEY: 0001522248
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39457
FILM NUMBER: 211059907
MAIL ADDRESS:
STREET 1: C/O TRIO MERGER CORP.
STREET 2: 777 THIRD AVENUE, 37TH FLOOR
CITY: NEW YORK
STATE: NY
ZIP: 10017
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Electric Last Mile Solutions, Inc.
CENTRAL INDEX KEY: 0001784168
STANDARD INDUSTRIAL CLASSIFICATION: MOTOR VEHICLES & PASSENGER CAR BODIES [3711]
IRS NUMBER: 000000000
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 1055 W. SQUARE LAKE ROAD
CITY: TROY
STATE: MI
ZIP: 48098
BUSINESS PHONE: 888-825-9111
MAIL ADDRESS:
STREET 1: 1055 W. SQUARE LAKE ROAD
CITY: TROY
STATE: MI
ZIP: 48098
FORMER COMPANY:
FORMER CONFORMED NAME: Forum Merger III Corp
DATE OF NAME CHANGE: 20190731
4
1
ownership.xml
X0306
4
2021-06-25
0
0001784168
Electric Last Mile Solutions, Inc.
ELMS
0001522248
Boris David
1055 W. SQUARE LAKE ROAD
TROY
MI
48098
1
0
0
0
Common Stock
2021-06-25
4
C
0
6250000
0
A
6250000
I
By Forum Investors III LLC
Class B Common Stock
2021-06-25
4
C
0
6250000
D
Common Stock
6250000
0
I
By Forum Investors III LLC
Private Placement Warrants
11.5
2021-06-25
4
A
0
205416
10.00
A
Common Stock
205416
205416
I
By Forum Investors III LLC
In connection with the closing (the "Closing") of the business combination (the "Business Combination") between the Issuer (which was formerly known as Forum Merger III Corporation or "Forum") and Electric Last Mile, Inc. ("ELM"), among other things, each share of Forum's Class B common stock converted pursuant to the terms of such stock into shares of the Issuer's common stock on a one-for-one basis.
Includes 616,250 shares of common stock included in the Private Placement Units, as described under the heading "Description of Securities" in Forum's registration statement on Form S-1 (File No. 333-240171), each of which separated into its component parts in connection with the Closing. Mr. Boris previously reported ownership of such shares under Section 16 of the Securities Exchange Act of 1934 (the "Exchange Act") as Class A Common Stock, which was renamed Common Stock at Closing.
The securities are held of record by Forum Investors III LLC ("Forum III"). Mr. Boris is a managing member of Forum Capital Management III LLC, which is the managing member of Forum III. As such, Mr. Boris may be deemed to have beneficial ownership of such securities. Mr. Boris disclaims beneficial ownership of the reported securities except to the extent of his pecuniary interest therein.
Represents 205,416 warrants included in the Private Placement Units, as described under the heading "Description of Securities" in Forum's registration statement on Form S-1 (File No. 333-240171), each of which separated into its component parts in connection with the Closing. These warrants are reported as acquired for purposes of Section 16 of the Exchange Act concurrently with the Closing, because they did not become derivative securities until such date based on the terms of their exercisability.
/s/ David Boris
2021-06-29