0001213900-21-032414.txt : 20210614 0001213900-21-032414.hdr.sgml : 20210614 20210614215011 ACCESSION NUMBER: 0001213900-21-032414 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210609 FILED AS OF DATE: 20210614 DATE AS OF CHANGE: 20210614 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Chopra Chandan CENTRAL INDEX KEY: 0001866013 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39116 FILM NUMBER: 211016685 MAIL ADDRESS: STREET 1: 5204 TENNYSON PKWY STREET 2: SUITE 500 CITY: PLANO STATE: TX ZIP: 75024 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Katapult Holdings, Inc. CENTRAL INDEX KEY: 0001785424 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-EQUIPMENT RENTAL & LEASING, NEC [7359] IRS NUMBER: 842704291 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1345 AVENUE OF THE AMERICAS 11TH FL CITY: NEW YORK STATE: NY ZIP: 10105 BUSINESS PHONE: 2123701300 MAIL ADDRESS: STREET 1: 1345 AVENUE OF THE AMERICAS 11TH FL CITY: NEW YORK STATE: NY ZIP: 10105 FORMER COMPANY: FORMER CONFORMED NAME: FinServ Acquisition Corp. DATE OF NAME CHANGE: 20190814 4 1 ownership.xml X0306 4 2021-06-09 0 0001785424 Katapult Holdings, Inc. KPLT 0001866013 Chopra Chandan C/O KATAPULT HOLDINGS, INC. 5204 TENNYSON PARKWAY, SUITE 500 PLANO TX 75024 0 1 0 0 CHIEF TECHNOLOGY OFFICER Common Stock 2021-06-09 4 J 0 97479 0 A 97479 D Stock Options (right to buy) 0.19 2021-06-09 4 A 0 148596 0 A 2021-06-09 2029-09-04 Common Stock 148596 148596 D Stock Options (right to buy) 0.85 2021-06-09 4 A 0 177060 0 A 2021-06-09 2028-07-03 Common Stock 177060 177060 D Stock Options (right to buy) 0.19 2021-06-09 4 A 0 656053 0 A 2021-06-09 2029-09-04 Common Stock 656053 656053 D Shares were acquired pursuant to Katapult Holdings, Inc.'s (the "Issuer") initial business combination in exchange for shares of the legacy Katapult Holdings, Inc. entity that were owned by the reporting person prior to the Closing. Includes earn out shares granted in connection with the Issuer's initial business combination, subject to certain vesting provisions. /s/ Chandan Chopra 2021-06-14