0001209191-21-066890.txt : 20211124
0001209191-21-066890.hdr.sgml : 20211124
20211124211655
ACCESSION NUMBER: 0001209191-21-066890
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20211123
FILED AS OF DATE: 20211124
DATE AS OF CHANGE: 20211124
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Olsen Christopher
CENTRAL INDEX KEY: 0001828005
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39658
FILM NUMBER: 211448949
MAIL ADDRESS:
STREET 1: C/O ROOT, INC.
STREET 2: 80 E RICH STREET, SUITE 500
CITY: COLUMBUS
STATE: OH
ZIP: 43215
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Root, Inc.
CENTRAL INDEX KEY: 0001788882
STANDARD INDUSTRIAL CLASSIFICATION: FIRE, MARINE & CASUALTY INSURANCE [6331]
IRS NUMBER: 842717903
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 80 E RICH STREET
STREET 2: SUITE 500
CITY: COLUMBUS
STATE: OH
ZIP: 43215
BUSINESS PHONE: (614) 591-4568
MAIL ADDRESS:
STREET 1: 80 E RICH STREET
STREET 2: SUITE 500
CITY: COLUMBUS
STATE: OH
ZIP: 43215
FORMER COMPANY:
FORMER CONFORMED NAME: Root Stockholdings, Inc.
DATE OF NAME CHANGE: 20190919
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2021-11-23
0
0001788882
Root, Inc.
ROOT
0001828005
Olsen Christopher
629 N. HIGH STREET, 6TH FLOOR
COLUMBUS
OH
43215
0
0
1
0
Class A Common Stock
2021-11-23
4
C
0
10100000
A
10100000
I
See Footnote
Class A Common Stock
2021-11-23
4
J
0
10100000
0.00
D
0
I
See Footnote
Class A Common Stock
15290
D
Class B Common Stock
2021-11-23
4
C
0
10100000
0.00
D
Class A Common Stock
10100000
25980779
I
See Footnote
Class B Common Stock
Class A Common Stock
2024456
2024456
I
See Footnote
Class B Common Stock
Class A Common Stock
978891
978891
I
See Footnote
Class B Common Stock
Class A Common Stock
28683
28683
I
See Footnote
These shares were converted from Class B Common Stock into Class A Common Stock on a one-for-one basis for no consideration.
The shares are held of record by DC I Investment LLC ("DC I Investment"). Christopher Olsen is the Managing Director of DC I Investment and has sole voting and dispositive power with respect to the shares held of record by DC I Investment.
Represents a pro-rata, in-kind distribution by DC I Investment LLC ("DC I Investment") to its indirect equity holders, without additional consideration. DC I Investment distributed an aggregate of 10,100,000 shares to the limited partners of its two members, Drive Capital Fund I, L.P. ("Fund I") and Drive Capital Ignition Fund I, L.P. ("Ignition Fund I"), on a pro rata basis.
Each share of Class B Common Stock is convertible into one share of Class A Common Stock at the option of the holder and has no expiration date.
The shares are held of record by Drive Capital Overdrive Fund I, L.P. ("Overdrive I"). Drive Capital Overdrive Fund I (GP), LLC ("Overdrive GP I") is the General Partner of Overdrive I. Christopher Olsen ("Olsen") and Mark Kvamme ("Kvamme") are the managing members of Overdrive GP I and share voting and dispositive power with respect to the shares held of record by Overdrive I. Overdrive GP I, Olsen and Kvamme disclaim beneficial ownership of such shares except to the extent of their pecuniary interests therein.
The shares are held of record by Drive Capital Overdrive Fund I (TE), L.P. ("Overdrive TE I"). Drive Capital Overdrive Fund I (GP), LLC ("Overdrive GP I") is the General Partner of Overdrive TE I. Christopher Olsen ("Olsen") and Mark Kvamme ("Kvamme") are the managing members of Overdrive GP I and share voting and dispositive power with respect to the shares held of record by Overdrive TE I. Overdrive GP I, Olsen and Kvamme disclaim beneficial ownership of such shares except to the extent of their pecuniary interests therein.
The shares are held of record by Drive Capital Overdrive Ignition Fund I, L.P. ("Overdrive Ignition I"). Drive Capital Overdrive Fund I (GP), LLC ("Overdrive GP I") is the General Partner of Overdrive Ignition I. Christopher Olsen ("Olsen") and Mark Kvamme ("Kvamme") are the managing members of Overdrive GP I and share voting and dispositive power with respect to the shares held of record by Overdrive Ignition I. Overdrive GP I, Olsen and Kvamme disclaim beneficial ownership of such shares except to the extent of their pecuniary interests therein.
This Form 4 is one of two Form 4s filed on the date hereof with respect to the conversion and in-kind distribution of shares by DC I Investment LLC to its indirect equity holders. The Reporting Person for the other Form 4 is Drive Capital Overdrive Fund I, L.P.
/s/ Christopher Olsen
2021-11-24