0000899243-21-032568.txt : 20210811
0000899243-21-032568.hdr.sgml : 20210811
20210811181830
ACCESSION NUMBER: 0000899243-21-032568
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210809
FILED AS OF DATE: 20210811
DATE AS OF CHANGE: 20210811
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Wagner Joseph F.
CENTRAL INDEX KEY: 0001839810
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39252
FILM NUMBER: 211164934
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: 725 COOL SPRINGS BLVD., SUITE 320
CITY: FRANKLIN
STATE: TN
ZIP: 37067
BUSINESS PHONE: (201) 432-2133
MAIL ADDRESS:
STREET 1: 725 COOL SPRINGS BLVD., SUITE 320
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
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2021-08-09
0
0001801170
CLOVER HEALTH INVESTMENTS, CORP. /DE
CLOV
0001839810
Wagner Joseph F.
C/O CLOVER HEALTH INVESTMENTS, CORP.
725 COOL SPRINGS BLVD., SUITE 320
FRANKLIN
TN
37067
0
1
0
0
Chief Financial Officer
Class A Common Stock
2021-08-09
4
C
0
25000
A
25000
D
Stock Options (right to buy)
2.23
2021-08-09
4
M
0
25000
0.00
D
2030-02-03
Class B Common Stock
25000
492018
D
Class B Common Stock
2.23
2021-08-09
4
M
0
25000
0.00
A
Class A Common Stock
25000
25000
D
Class B Common Stock
2021-08-09
4
C
0
25000
0.00
D
Class A Common Stock
25000
0
D
The Class B Common Stock will be convertible into shares of Class A Common Stock on a one-to-one basis at the option of the holders of the Class B Common Stock at any time upon written notice to the Issuer. In addition, the Class B Common Stock will automatically convert into shares of Class A Common Stock immediately prior to the close of business on the earliest to occur of certain events specified in the Issuer's Amended and Restated Certificate of Incorporation.
100% of the stock option is immediately exercisable. The stock option vested as to 1/5th of the total number of shares on December 30, 2020 and continues to vest as to 1/60th of the total number of shares in equal monthly installments thereafter, subject to the continuous service of the Reporting Person on each vesting date.
Joseph Wagner
2021-08-11