0000895345-23-000254.txt : 20230426 0000895345-23-000254.hdr.sgml : 20230426 20230426215606 ACCESSION NUMBER: 0000895345-23-000254 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230314 FILED AS OF DATE: 20230426 DATE AS OF CHANGE: 20230426 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Martin Joseph Richards CENTRAL INDEX KEY: 0001776869 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39252 FILM NUMBER: 23851541 MAIL ADDRESS: STREET 1: C/O LOUISIANA-PACIFIC CORPORATION STREET 2: 414 UNION STREET, SUITE 2000 CITY: NASHVILLE STATE: TN ZIP: 37219 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 form4.xml X0407 4 2023-03-14 0001801170 CLOVER HEALTH INVESTMENTS, CORP. /DE CLOV 0001776869 Martin Joseph Richards C/O LOUISIANA-PACIFIC CORPORATION 3401 LORY LANE, SUITE 210 FRANKLIN TN 37067 true General Counsel false Class A Common Stock 2023-03-14 4 F 0 283091 0.93 D 2817684 D Represents shares of the Issuer's Class A Common Stock that were automatically withheld by the Issuer to cover the Reporting Person's tax obligations upon the vesting, on March 14, 2023, of 25% of the original number of time-based restricted stock units ("RSUs") granted to the Reporting Person on March 14, 2022, and timely reported on a Form 4 filed on March 15, 2022. The remaining RSUs vest in twelve equal quarterly installments beginning on the date that is three months after March 14, 2023, in each case subject to the continued service of the Reporting Person on each such vesting date. /s/ Joseph R. Martin 2023-04-26