0000895345-23-000255.txt : 20230426
0000895345-23-000255.hdr.sgml : 20230426
20230426215657
ACCESSION NUMBER: 0000895345-23-000255
CONFORMED SUBMISSION TYPE: 4/A
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20220131
FILED AS OF DATE: 20230426
DATE AS OF CHANGE: 20230426
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Reynoso Jamie L.
CENTRAL INDEX KEY: 0001839066
FILING VALUES:
FORM TYPE: 4/A
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39252
FILM NUMBER: 23851543
MAIL ADDRESS:
STREET 1: C/O CLOVER HEALTH INVESTMENTS, CORP.
STREET 2: 725 COOL SPRINGS BLVD., SUITE 320
CITY: FRANKLIN
STATE: TN
ZIP: 37067
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: CLOVER HEALTH INVESTMENTS, CORP. /DE
CENTRAL INDEX KEY: 0001801170
STANDARD INDUSTRIAL CLASSIFICATION: HOSPITAL & MEDICAL SERVICE PLANS [6324]
IRS NUMBER: 981515192
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 3401 MALLORY LANE, SUITE 210
CITY: FRANKLIN
STATE: TN
ZIP: 37067
BUSINESS PHONE: (201) 432-2133
MAIL ADDRESS:
STREET 1: 3401 MALLORY LANE, SUITE 210
CITY: FRANKLIN
STATE: TN
ZIP: 37067
FORMER COMPANY:
FORMER CONFORMED NAME: CLOVER HEALTH INVESTMENTS, CORP.
DATE OF NAME CHANGE: 20210107
FORMER COMPANY:
FORMER CONFORMED NAME: Social Capital Hedosophia Holdings Corp. III
DATE OF NAME CHANGE: 20200124
4/A
1
form4.xml
X0407
4/A
2022-01-31
2022-02-02
0001801170
CLOVER HEALTH INVESTMENTS, CORP. /DE
CLOV
0001839066
Reynoso Jamie L.
C/O CLOVER HEALTH INVESTMENTS, CORP.
3401 LORY LANE, SUITE 210
FRANKLIN
TN
37067
true
CEO of Medicare Advantage
false
Class A Common Stock
2022-01-31
4
F
0
1281
2.58
D
235310
D
This Form 4/A, amends the original Form 4, filed on February 2, 2022, solely to report the number of shares of the Issuer's Class A Common Stock that were automatically withheld by the Issuer to cover the Reporting Person's tax obligations upon the vesting, on January 31, 2022, of 1/3rd of the original number of time-based restricted stock units ("RSUs") granted to the Reporting Person on January 31, 2022 upon the achievement of certain performance criteria. The RSUs vest in equal installments on January 31, 2022, January 1, 2023 and January 1, 2024.
The original Form 4 inadvertently omitted the 1,281 shares that were withheld in connection with the January 31, 2022 vesting event.
/s/ Joseph R. Martin as attorney-in-fact for Jamie L. Reynoso
2023-04-26