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