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