0001628280-22-000725.txt : 20220111 0001628280-22-000725.hdr.sgml : 20220111 20220111212317 ACCESSION NUMBER: 0001628280-22-000725 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220107 FILED AS OF DATE: 20220111 DATE AS OF CHANGE: 20220111 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Robinson William G Jr CENTRAL INDEX KEY: 0001604046 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39252 FILM NUMBER: 22525352 MAIL ADDRESS: STREET 1: 3150 SABRE DRIVE CITY: SOUTHLAKE STATE: TX ZIP: 76092 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: CLOVER HEALTH INVESTMENTS, CORP. /DE CENTRAL INDEX KEY: 0001801170 STANDARD INDUSTRIAL CLASSIFICATION: HOSPITAL & MEDICAL SERVICE PLANS [6324] IRS NUMBER: 981515192 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 3401 MALLORY LANE, SUITE 210 CITY: FRANKLIN STATE: TN ZIP: 37067 BUSINESS PHONE: (201) 432-2133 MAIL ADDRESS: STREET 1: 3401 MALLORY LANE, SUITE 210 CITY: FRANKLIN STATE: TN ZIP: 37067 FORMER COMPANY: FORMER CONFORMED NAME: CLOVER HEALTH INVESTMENTS, CORP. DATE OF NAME CHANGE: 20210107 FORMER COMPANY: FORMER CONFORMED NAME: Social Capital Hedosophia Holdings Corp. III DATE OF NAME CHANGE: 20200124 4 1 wf-form4_164195418269205.xml FORM 4 X0306 4 2022-01-07 0 0001801170 CLOVER HEALTH INVESTMENTS, CORP. /DE CLOV 0001604046 Robinson William G Jr C/O CLOVER HEALTH INVESTMENTS, CORP. 3401 MALLORY LANE, SUITE 210 FRANKLIN TN 37067 1 0 0 0 Class A Common Stock 2022-01-07 4 M 0 27100 0 A 27100 D Restricted Stock Unit 2022-01-07 4 M 0 27100 0 D Class A Common Stock 27100.0 27100 D Each restricted stock unit ("RSU") represents a contingent right to receive one share of the Issuer's Class A Common Stock upon settlement for no consideration. The RSUs vested as to 50% of the shares subject to the award on January 7, 2022, and will vest as to the remaining shares subject to the award on the date of the 2022 Annual Meeting, subject to the Reporting Person's continued service as a member of the Board through such vesting date. /s/ Gia Lee, as Attorney-in-Fact 2022-01-12