SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person*
BEP III LLC

(Last) (First) (Middle)
201 TRESSER BOULEVARD
SUITE 320

(Street)
STAMFORD CT 06901

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
05/20/2020
3. Issuer Name and Ticker or Trading Symbol
SelectQuote, Inc. [ SLQT ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director X 10% Owner
Officer (give title below) X Other (specify below)
Member of 10% owner group
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Series D Convertible Preferred Stock(1) 07/23/2014 (2) Common Stock 15,470,824 (2) D
Series D Convertible Preferred Stock(1) 07/23/2014 (2) Common Stock 12,044,344 (2) I Owned by wholly-owned subsidiary, BEP III Co-Invest LLC
Explanation of Responses:
1. Par value $0.01 per share.
2. The Series D Convertible Preferred Stock (the "Series D") is convertible into SelectQuote, Inc. Common Stock, par value $0.01 per share ("Common Stock"). on an 8 to 1 basis for no consideration at any time while the Series D is outstanding. The number of underlying shares of Common Stock reported in column 3 reflects an 8 to 1 forward stock split effective as of February 28, 2020. Upon the closing of the Issuer's initial public offering, each share of Series D will be automatically converted into 8 shares of Common Stock.
/s/ ___________________ Manager on behalf of BEP III LLC 05/20/2020
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
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