0001209191-21-046356.txt : 20210712 0001209191-21-046356.hdr.sgml : 20210712 20210712190928 ACCESSION NUMBER: 0001209191-21-046356 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210708 FILED AS OF DATE: 20210712 DATE AS OF CHANGE: 20210712 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Singh Prabhdeep CENTRAL INDEX KEY: 0001870027 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39252 FILM NUMBER: 211086427 BUSINESS ADDRESS: BUSINESS PHONE: 518-727-6868 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 2021-07-08 0 0001801170 CLOVER HEALTH INVESTMENTS, CORP. /DE CLOV 0001870027 Singh Prabhdeep C/O CLOVER HEALTH INVESTMENTS, CORP. 725 COOL SPRINGS BLVD., SUITE 320 FRANKLIN TN 37067 0 1 0 0 Chief Growth Officer Class A Common Stock 2021-07-08 4 A 0 211193 0.00 A 211193 D Class A Common Stock 2021-07-08 4 A 0 52798 0.00 A 263991 D Represents shares of Class A common stock underlying a time-based restricted stock unit award ("RSUs"). The RSUs will vest in equal annual installments over four years, beginning on July 6, 2022, subject to the continuous service of the Reporting Person on each vesting date. Represents shares of Class A common stock underlying RSUs. The RSUs will vest in full on July 6, 2022, subject to the continuous service of the Reporting Person on such vesting date. /s/ Gia Lee, as Attorney-in-Fact 2021-07-12