0000899243-21-010548.txt : 20210308 0000899243-21-010548.hdr.sgml : 20210308 20210308214618 ACCESSION NUMBER: 0000899243-21-010548 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210308 FILED AS OF DATE: 20210308 DATE AS OF CHANGE: 20210308 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Independence Sponsor LLC CENTRAL INDEX KEY: 0001837381 STATE OF INCORPORATION: E9 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40178 FILM NUMBER: 21723952 BUSINESS ADDRESS: STREET 1: 277 PARK AVENUE STREET 2: 29TH FLOOR, SUITE B CITY: NEW YORK STATE: NY ZIP: 10172 BUSINESS PHONE: 2127043050 MAIL ADDRESS: STREET 1: 277 PARK AVENUE STREET 2: 29TH FLOOR, SUITE B CITY: NEW YORK STATE: NY ZIP: 10172 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Independence Holdings Corp. CENTRAL INDEX KEY: 0001837393 STANDARD INDUSTRIAL CLASSIFICATION: BLANK CHECKS [6770] IRS NUMBER: 000000000 STATE OF INCORPORATION: E9 FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 277 PARK AVENUE STREET 2: 29TH FLOOR, SUITE B CITY: NEW YORK STATE: NY ZIP: 10172 BUSINESS PHONE: 2127043050 MAIL ADDRESS: STREET 1: 277 PARK AVENUE STREET 2: 29TH FLOOR, SUITE B CITY: NEW YORK STATE: NY ZIP: 10172 3 1 doc3.xml FORM 3 SUBMISSION X0206 3 2021-03-08 0 0001837393 Independence Holdings Corp. ACQRU 0001837381 Independence Sponsor LLC 277 PARK AVENUE, 29TH FLOOR SUITE B NEW YORK NY 10172 0 0 1 0 Class B Ordinary Shares Class A Ordinary Shares 12431250 D As described in the issuer's registration statement on Form S-1 (File No. 333-253095) (the "Registration Statement") under the heading "Description of Securities - Founder Shares", Class B ordinary shares will automatically convert into Class A ordinary shares at the time of the issuer's initial business combination, on a one-for-one basis, subject to certain adjustments described therein, and have no expiration date. The Class B ordinary shares held directly by Independence Sponsor LLC (the "Sponsor") were acquired pursuant to a subscription agreement by and between the Sponsor and the issuer. The Class B ordinary shares owned by the Sponsor include up to 1,631,250 shares that are subject to forfeiture in the event the underwriters of the issuer's initial public offering do not exercise in full their over-allotment option, as described in the Registration Statement. Steven J. McLaughlin, the Co-Chairman of the issuer, and Eugene Yoon, the Co-Chairman of the issuer, are Co-Managing Members of the Sponsor. As such, each of Messrs. McLaughlin and Yoon may be deemed to have indirect beneficial ownership of Class B ordinary shares held directly by the sponsor. Messrs. McLaughlin and Yoon disclaim any beneficial ownership of the reported shares other than to the extent of any pecuniary interest they may have therein. Independence Sponsor LLC, by George Barrios, its managing member, /s/ Steven J. McLaughlin, Steven J. McLaughlin 2021-03-08 Independence Sponsor LLC, by Michelle Wilson, its managing member, /s/ Eugene Yoon, Eugene Yoon 2021-03-08