0001628280-21-017966.txt : 20210901 0001628280-21-017966.hdr.sgml : 20210901 20210901190139 ACCESSION NUMBER: 0001628280-21-017966 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210830 FILED AS OF DATE: 20210901 DATE AS OF CHANGE: 20210901 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: KHALIL DAVID CENTRAL INDEX KEY: 0001838024 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38252 FILM NUMBER: 211231335 MAIL ADDRESS: STREET 1: C/O SPARK NETWORKS SE STREET 2: KOHLFURTER STRASSE 41/43 CITY: BERLIN STATE: X9 ZIP: 10999 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Spark Networks SE CENTRAL INDEX KEY: 0001705338 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PERSONAL SERVICES [7200] IRS NUMBER: 000000000 STATE OF INCORPORATION: 2M BUSINESS ADDRESS: STREET 1: KOHLFURTER STRASSE 41/43 CITY: BERLIN STATE: 2M ZIP: 10999 BUSINESS PHONE: 011491624265474 MAIL ADDRESS: STREET 1: KOHLFURTER STRASSE 41/43 CITY: BERLIN STATE: 2M ZIP: 10999 FORMER COMPANY: FORMER CONFORMED NAME: Blitz 17655 SE DATE OF NAME CHANGE: 20170501 4 1 wf-form4_163053728609218.xml FORM 4 X0306 4 2021-08-30 0 0001705338 Spark Networks SE LOV 0001838024 KHALIL DAVID C/O SPARK NETWORKS SE KOHLFURTER STRASSE 41/43 BERLIN 2M 10999 GERMANY 1 0 0 0 American Depository Shares 2021-08-30 4 J 0 521904 0 D 521904 I Lino Holding GmbH and Co KG American Depository Shares 12938 D Each American Depository Share ("ADS") represents 0.1 Ordinary Shares of Spark Networks SE. Affinitas Phantom distributed, on a pro rata basis, ADSs to limited partners in Affinitas Phantom as part of a pro rata distribution These shares were previously held by Affinitas Phantom Share GmbH and distributed to limited partners, including Lino Holdings GmbH and Co KG, as part of a pro rata distribution. /s/ David Khalil 2021-09-01