0001628280-22-022231.txt : 20220810 0001628280-22-022231.hdr.sgml : 20220810 20220810163329 ACCESSION NUMBER: 0001628280-22-022231 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220808 FILED AS OF DATE: 20220810 DATE AS OF CHANGE: 20220810 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Toy Andrew CENTRAL INDEX KEY: 0001838733 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39252 FILM NUMBER: 221152302 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 1 wf-form4_166016358247135.xml FORM 4 X0306 4 2022-08-08 0 0001801170 CLOVER HEALTH INVESTMENTS, CORP. /DE CLOV 0001838733 Toy Andrew C/O CLOVER HEALTH INVESTMENTS, CORP. 3401 MALLORY LANE, SUITE 210 FRANKLIN TN 37067 1 1 0 0 President Class A Common Stock 2022-08-08 4 A 0 2695072 0 A 2695072 D Represents shares of Class A common stock underlying a time-based restricted stock unit award ("RSUs"). Twenty-five percent of the RSUs will vest on the first anniversary of August 8, 2022, and the remaining RSUs will vest in twelve equal quarterly installments beginning on the date that is three months after the first anniversary of August 8, 2022, in each case subject to the continued service of the Reporting Person on each such vesting date. /s/ Jamie L. Reynoso, as Attorney-in-Fact 2022-08-10