0000899243-21-016584.txt : 20210421 0000899243-21-016584.hdr.sgml : 20210421 20210421160541 ACCESSION NUMBER: 0000899243-21-016584 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210419 FILED AS OF DATE: 20210421 DATE AS OF CHANGE: 20210421 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Chen Mo CENTRAL INDEX KEY: 0001851985 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40326 FILM NUMBER: 21841483 MAIL ADDRESS: STREET 1: 9191 TOWNE CENTRE DRIVE STE 600 CITY: SAN DIEGO STATE: CA ZIP: 92122 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Gray Jade Holding Ltd CENTRAL INDEX KEY: 0001856509 STATE OF INCORPORATION: D8 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40326 FILM NUMBER: 21841482 BUSINESS ADDRESS: STREET 1: SERTUS CHAMBERS, P.O. BOX 905 STREET 2: QUASTISKY BUILDING, ROAD TOWN CITY: TORTOLA STATE: D8 ZIP: VG 1110 BUSINESS PHONE: (619) 916-3144 MAIL ADDRESS: STREET 1: SERTUS CHAMBERS, P.O. BOX 905 STREET 2: QUASTISKY BUILDING, ROAD TOWN CITY: TORTOLA STATE: D8 ZIP: VG 1110 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: TuSimple Holdings Inc. CENTRAL INDEX KEY: 0001823593 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMPUTER INTEGRATED SYSTEMS DESIGN [7373] IRS NUMBER: 862341575 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 9191 TOWNE CENTRE DRIVE, SUITE 600 CITY: SAN DIEGO STATE: CA ZIP: 92122 BUSINESS PHONE: (619) 916-3144 MAIL ADDRESS: STREET 1: 9191 TOWNE CENTRE DRIVE, SUITE 600 CITY: SAN DIEGO STATE: CA ZIP: 92122 FORMER COMPANY: FORMER CONFORMED NAME: Tusimple (Cayman) Ltd DATE OF NAME CHANGE: 20200903 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2021-04-19 0 0001823593 TuSimple Holdings Inc. TSP 0001851985 Chen Mo 9191 TOWNE CENTRE DRIVE, STE 600 SAN DIEGO CA 92122 1 1 1 0 Executive Chairman 0001856509 Gray Jade Holding Ltd 9191 TOWNE CENTRE DRIVE, STE 600 SAN DIEGO CA 92122 0 0 1 0 Common Stock 2021-04-19 4 J 0 20000000 D 0 I By corporation Common Stock 2021-04-19 4 J 0 75000 D 0 I By corporation Common Stock 2021-04-19 4 J 0 6292314 D 0 I By corporation Class A Common Stock 2021-04-19 4 J 0 20000000 A 20000000 I By corporation Class A Common Stock 2021-04-19 4 J 0 75000 A 75000 I By corporation Class A Common Stock 2021-04-19 4 J 0 6292314 A 6292314 I By corporation Class A Common Stock 2021-04-19 4 J 0 12000000 D 8000000 I By corporation Class B Common Stock 2021-04-19 4 J 0 12000000 0.00 A Class A Common Stock 12000000 12000000 I By corporation Pursuant to a reclassification exempt under Rule 16b-7, each share of Common Stock was automatically reclassified into one share of Class A Common Stock immediately prior to the completion of the Issuer's initial public offering of Class A Common Stock. The shares are held by Gray Jade Holding Limited, a company incorporated in British Virgin Islands and beneficially owned by the Reporting Person. The shares are held by THC International Limited, a company incorporated in British Virgin Islands and beneficially owned by the Reporting Person. The shares are held by Brown Jade Holding Limited, a company incorporated in British Virgin Islands and beneficially owned by the Reporting Person. Following the reclassification of Common Stock into Class A Common Stock, certain shares of Class A Common Stock were exchanged at a 1:1 ratio for shares of Class B Common Stock in a transaction previously approved by the Issuer's board of directors. Each share of Class B Common Stock is convertible into one share of Class A Common Stock at the option of the holder and has no expiration date. Mo Chen, By: /s/ James Mullen, Attorney-in-Fact 2021-04-21 Gray Jade Holding Limited, By: /s/ James Mullen, Attorney-in-Fact 2021-04-21