0001104659-20-139758.txt : 20201228 0001104659-20-139758.hdr.sgml : 20201228 20201228161520 ACCESSION NUMBER: 0001104659-20-139758 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20201228 FILED AS OF DATE: 20201228 DATE AS OF CHANGE: 20201228 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: HAAC Sponsor, LLC CENTRAL INDEX KEY: 0001831110 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39702 FILM NUMBER: 201418529 BUSINESS ADDRESS: STREET 1: C/O GENERAL CATALYST STREET 2: 20 UNIVERSITY ROAD, FOURTH FLOOR CITY: CAMBRIDGE STATE: MA ZIP: 02138 BUSINESS PHONE: 617-234-7000 MAIL ADDRESS: STREET 1: C/O GENERAL CATALYST STREET 2: 20 UNIVERSITY ROAD, FOURTH FLOOR CITY: CAMBRIDGE STATE: MA ZIP: 02138 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Health Assurance Acquisition Corp. CENTRAL INDEX KEY: 0001824013 STANDARD INDUSTRIAL CLASSIFICATION: BLANK CHECKS [6770] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 20 UNIVERSITY ROAD, FOURTH FLOOR CITY: CAMBRIDGE STATE: MA ZIP: 02138 BUSINESS PHONE: 617-234-7000 MAIL ADDRESS: STREET 1: 20 UNIVERSITY ROAD, FOURTH FLOOR CITY: CAMBRIDGE STATE: MA ZIP: 02138 FORMER COMPANY: FORMER CONFORMED NAME: Healthcare Assurance Acquisition Corp. DATE OF NAME CHANGE: 20200909 4 1 tm2039376d1_4.xml OWNERSHIP DOCUMENT X0306 4 2020-12-28 0 0001824013 Health Assurance Acquisition Corp. HAAC 0001831110 HAAC Sponsor, LLC 20 UNIVERSITY ROAD CAMBRIDGE MA 02138 0 0 1 0 Class B common stock 2020-12-28 4 D 0 250000 D Class A common stock 250000 2311624 D This Form 4 reflects the automatic surrender to the issuer of 250,000 of the issuer's shares of Class B common stock, par value $0.0001 per share, for no consideration by the reporting person as a result of HAAC Sponsor's ("Sponsor") participation in the issuer's initial public offering and in connection with the expiration of the underwriters' over-allotment option, as more fully described in the issuer's registration statement on Form S-1 (File No. 333- 249667). As described in the issuer's registration statement on Form S-1 (File No. 333- 249667) under the heading "Description of Securities -- Alignment Shares", the shares of Class B common stock will convert into shares of Class A common stock, par value $0.0001, pursuant to the performance of publicly traded shares of Class A common stock of the issuer after the consummation of the issuer's initial business combination. This Form 4 is being filed by the Sponsor. Sponsor is controlled by an affiliate of the Sponsor. HAAC Sponsor, LLC, By: /s/ Evan Sotiriou, Chief Operating Officer 2020-12-28