0000899243-22-001267.txt : 20220106 0000899243-22-001267.hdr.sgml : 20220106 20220106192049 ACCESSION NUMBER: 0000899243-22-001267 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220105 FILED AS OF DATE: 20220106 DATE AS OF CHANGE: 20220106 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Kloppenburg Janet CENTRAL INDEX KEY: 0001842057 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40161 FILM NUMBER: 22516152 MAIL ADDRESS: STREET 1: C/O MAPLES CORPORATE SERVICES LIMITED STREET 2: PO BOX 309, UGLAND HOUSE CITY: GEORGE TOWN STATE: E9 ZIP: KY1-1104 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: VPC Impact Acquisition Holdings III, Inc. CENTRAL INDEX KEY: 0001841408 STANDARD INDUSTRIAL CLASSIFICATION: FINANCE SERVICES [6199] IRS NUMBER: 000000000 FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 150 NORTH RIVERSIDE PLAZA STREET 2: SUITE 5200 CITY: CHICAGO STATE: IL ZIP: 60606 BUSINESS PHONE: 312-701-1777 MAIL ADDRESS: STREET 1: 150 NORTH RIVERSIDE PLAZA STREET 2: SUITE 5200 CITY: CHICAGO STATE: IL ZIP: 60606 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2022-01-05 1 0001841408 VPC Impact Acquisition Holdings III, Inc. DAVE 0001842057 Kloppenburg Janet C/O VICTORY PARK CAPITAL ADVISORS, LLC 150 NORTH RIVERSIDE PLAZA, SUITE 5200 CHICAGO IL 60606 1 0 0 0 Class A common stock, par value $0.001 per share 2022-01-05 4 M 0 17000 A 17000 D Class B common stock, par value $0.0001 2022-01-05 4 D 0 3000 0.00 D Class A common stock 3000 17000 D Class B common stock, par value $0.0001 2022-01-05 4 M 0 17000 0.00 D Class A common stock 17000 0 D In connection with the closing (the "Closing") of the business combination (the "Business Combination") between the Issuer (which was formerly known as VPC Impact Acquisition Holdings III, Inc. or "VPCC") and Dave Inc. ("Dave"), among other things, (i) Janet Kloppenburg forfeited at no cost 3,000 shares of Class B common stock of VPCC and (ii) each of the remaining issued and outstanding shares of Class B common stock of VPCC converted into shares of Class A common stock of VPCC on a one-for-one basis as described under the heading "Description of Securities" in the Issuer's Registration Statement on Form S-1 (File No. 333-252577). /s/ Brian Munsie, Attorney-in-Fact for Janet Kloppenburg 2022-01-06