0001567619-21-012729.txt : 20210629
0001567619-21-012729.hdr.sgml : 20210629
20210629172425
ACCESSION NUMBER: 0001567619-21-012729
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: Li Albert
CENTRAL INDEX KEY: 0001868871
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39457
FILM NUMBER: 211059272
MAIL ADDRESS:
STREET 1: 1055 W. SQUARE LAKE ROAD
CITY: TROY
STATE: MI
ZIP: 48098
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
doc1.xml
FORM 4
X0306
4
2021-06-25
0
0001784168
Electric Last Mile Solutions, Inc.
ELMS
0001868871
Li Albert
1055 W SQUARE LAKE ROAD
TROY
MI
48098
0
1
0
0
CFO & Treasurer
Common Stock
2021-06-25
4
C
0
88071
A
88071
I
by Li Management and Consulting LLC
Common Stock
2021-06-25
4
C
0
22017
A
22017
I
by H and L Reunion Investments LLC
Convertible Note
2021-06-25
4
C
0
88071
D
Common Stock
88071
0
I
by Li Management and Consulting LLC
Convertible Note
2021-06-25
4
C
0
22017
D
Common Stock
22017
0
I
by H and L Reunion Investments LLC
Shares were issued to the reporting person upon conversion of an aggregate of $800,647.67 in principal and accrued interest under a convertible note owed to the reporting person.
The reporting person is the sole member of Li Management and Consulting LLC, and as such has sole voting and investment power with respect to the common stock held by Li Management and Consulting LLC.
Shares were issued to the reporting person upon conversion of an aggregate of $200,161.92 in principal and accrued interest under a convertible note owed to the reporting person.
The reporting person and Gary Heald have shared voting and investment power with respect to the common stock held by H and L Reunion Investments LLC. Accordingly, the reporting person and Mr. Heald may be deemed to have beneficial ownership of the common stock held by H and L Reunion Investments LLC.
On December 10, 2020, Electric Last Mile, Inc. ("ELM") entered into a $800,000 Convertible Note with Li Management and Consulting LLC. The reporting person is the beneficial owner of the Convertible Note issued to Li Management and Consulting LLC. Pursuant to the terms of the Convertible Note, upon the closing of the transaction contemplated pursuant to the Agreement and Plan of Merger, dated as of December 10, 2020, by and among Forum Merger III Corporation ("Forum") (upon consummation of the business combination, the surviving "Issuer" is renamed "Electric Last Mile Solutions, Inc."), ELMS Merger Corp., a wholly owned subsidiary of Forum, and ELM, as amended, the Convertible Note will be converted into shares of common stock of Electric Last Mile Solutions, Inc.
On December 10, 2020, Electric Last Mile, Inc. ("ELM") entered into a $200,000 Convertible Note with H and L Reunion Investments LLC. The reporting person is the beneficial owner of the Convertible Note issued to H and L Reunion Investments LLC. Pursuant to the terms of the Convertible Note, upon the closing of the transaction contemplated pursuant to the Agreement and Plan of Merger, dated as of December 10, 2020, by and among Forum Merger III Corporation ("Forum") (upon consummation of the business combination, the surviving "Issuer" is renamed "Electric Last Mile Solutions, Inc."), ELMS Merger Corp., a wholly owned subsidiary of Forum, and ELM, as amended, the Convertible Note will be converted into shares of common stock of Electric Last Mile Solutions, Inc.
/s/ Benjamin Wu, attorney-in-fact for Albert Li
2021-06-29