0001209191-21-048729.txt : 20210729 0001209191-21-048729.hdr.sgml : 20210729 20210729215127 ACCESSION NUMBER: 0001209191-21-048729 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20210729 FILED AS OF DATE: 20210729 DATE AS OF CHANGE: 20210729 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Hashim Mir CENTRAL INDEX KEY: 0001875891 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40672 FILM NUMBER: 211129839 MAIL ADDRESS: STREET 1: C/O RANI THERAPEUTICS HOLDINGS, INC. STREET 2: 2051 RINGWOOD AVENUE CITY: SAN JOSE STATE: CA ZIP: 95131 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Rani Therapeutics Holdings, Inc. CENTRAL INDEX KEY: 0001856725 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 2051 RINGWOOD AVENUE CITY: SAN JOSE STATE: CA ZIP: 95131 BUSINESS PHONE: (408) 457-3700 MAIL ADDRESS: STREET 1: 2051 RINGWOOD AVENUE CITY: SAN JOSE STATE: CA ZIP: 95131 3 1 doc3.xml FORM 3 SUBMISSION X0206 3 2021-07-29 0 0001856725 Rani Therapeutics Holdings, Inc. RANI 0001875891 Hashim Mir C/O RANI THERAPEUTICS LLC 2051 RINGWOOD AVE. SAN JOSE CA 95131 0 1 0 0 Chief Scientific Officer Class B Common Stock 232707 D Class A Common LLC Units Class A Common Stock 786392 D Stock Option (Right to Buy) 6.99 2031-07-28 Class A Common Stock 285920 D Represents Common LLC Units of Rani Therapeutics, LLC, a direct subsidiary of the Issuer. The Common LLC Units are redeemable at the election of the Reporting Person at any time for newly-issued Class A Common Stock of the Issuer ("Class A Shares") on a one-for-one basis or, if mutually agreed with the Issuer, a cash payment equal to the volume weighted average market price of one Class A Share for each Common LLC Unit redeemed (subject to customary adjustments, including for stock splits, stock dividends and reclassifications). However, the Issuer may elect to effect a direct exchange of such Class A Shares (or such cash, if mutually agreed) for such Common LLC Units. The shares subject to the option vest as follows: 1/48th of the shares subject to the option vest monthly over four years from June 17, 2021. Exhibit 24 - Power of Attorney /s/ Josh Seidenfeld, Attorney-in-Fact for Mir Hashim 2021-07-29 EX-24.3_1001138 2 poa.txt POA DOCUMENT LIMITED POWER OF ATTORNEY FOR SECTION 16 REPORTING OBLIGATIONS Know all by these presents, that the undersigned hereby constitutes and appoints Talat Imran and Svai Sanford of Rani Therapeutics Holdings, Inc. and Josh Seidenfeld and Nguyen X. Nguyen of Cooley LLP, or any of them signing singly, with full power of substitution, the undersigned's true and lawful attorney in fact to: (1) execute for and on behalf of the undersigned, in the undersigned's capacity as an officer, director or beneficial owner of more than 10% of a registered class of securities of Rani Therapeutics Holdings, Inc. (the "Company"), Forms 3, 4 and 5 (including any amendments thereto) in accordance with Section 16(a) of the Securities Exchange Act of 1934, as amended (the "Exchange Act") and the rules thereunder and a Form ID, Uniform Application for Access Codes to File on EDGAR; (2) do and perform any and all acts for and on behalf of the undersigned that may be necessary or desirable to execute such Forms 3, 4 or 5 or Form ID (including any amendments thereto) and timely file such forms with the United States Securities and Exchange Commission and any stock exchange or similar authority; and (3) take any other action of any nature whatsoever in connection with the foregoing which, in the opinion of such attorney-in-fact, may be of benefit, in the best interest of, or legally required by, the undersigned, it being understood that the documents executed by such attorney-in-fact on behalf of the undersigned pursuant to this Power of Attorney shall be in such form and shall contain such terms and conditions as such attorney-in-fact may approve in such attorney-in-fact's discretion. The undersigned hereby grants to each such attorney-in-fact full power and authority to do and perform any and every act and thing whatsoever requisite, necessary or proper to be done in the exercise of any of the rights and powers herein granted, as fully to all intents and purposes as the undersigned might or could do if personally present, with full power of substitution or revocation, hereby ratifying and confirming all that such attorney-in-fact, or such attorney-in-fact's substitute or substitutes, shall lawfully do or cause to be done by virtue of this power of attorney and the rights and powers herein granted. The undersigned acknowledges that the foregoing attorneys-in-fact, in serving in such capacity at the request of the undersigned, are not assuming, nor is the Company assuming, any of the undersigned's responsibilities to comply with Section 16 of the Exchange Act. This Power of Attorney shall remain in full force and effect until the earliest to occur of (a) the undersigned is no longer required to file Forms 3, 4 and 5 with respect to the undersigned's holdings of and transactions in securities issued by the Company, (b) revocation by the undersigned in a signed writing delivered to the foregoing attorneys-in-fact or (c) as to any attorney-in-fact individually, until such attorney-in-fact is no longer employed by the Company or Cooley LLP. IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be executed as of this 17th day of July, 2021. /s/ Mir Hashim Mir Hashim