Annual Statement of Changes in Beneficial Ownership (5)
14 Februar 2022 - 11:13PM
Edgar (US Regulatory)
FORM 5
[ ]
Check this box if no longer subject to Section 16. Form 4 or Form 5
obligations may continue. See Instruction 1(b).
[ ] Form 3 Holdings Reported
[ ] Form 4 Transactions Reported
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
ANNUAL STATEMENT OF CHANGES IN BENEFICIAL
OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number: 3235-0362
Estimated average burden
hours per response... 1.0 |
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Filed pursuant to Section 16(a) of the
Securities Exchange Act of 1934 or Section 30(h) of the Investment
Company Act of 1940
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| 1. Name
and Address of Reporting Person * Lohr Gernot |
2. Issuer Name and Ticker or Trading
SymbolAthene Holding Ltd [ATH] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)__X__
Director _____
10% Owner
_____ Officer (give title
below) _____ Other
(specify below)
|
|
(Last)
(First)
(Middle)
C/O APOLLO MANAGEMENT, L.P.,, 9 W. 57TH STREET, 43RD
FLOOR |
3. Statement for Issuer's Fiscal Year Ended
(MM/DD/YYYY)
12/31/2021
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(Street)
NEW YORK, NY 10019
(City)
(State)
(Zip)
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4. If Amendment, Date Original
Filed(MM/DD/YYYY)
|
6. Individual or Joint/Group
Filing(Check Applicable
Line)_X_ Form Filed by One Reporting
Person
___ Form Filed by More than One Reporting Person |
Table I - Non-Derivative Securities Acquired, Disposed of, or
Beneficially Owned
|
1.Title of Security
(Instr. 3) |
2. Trans. Date |
2A. Deemed Execution Date, if any |
3. Trans. Code
(Instr. 8) |
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5) |
5. Amount of Securities Beneficially Owned Following
Reported Transaction(s)
(Instr. 3 and 4) |
6. Ownership Form: Direct (D) or Indirect (I)
(Instr. 4) |
7. Nature of Indirect Beneficial Ownership
(Instr. 4) |
|
Amount |
(A) or (D) |
Price |
|
Class A Common Shares |
2/23/2021 |
|
G (1) |
1672719 (2) |
D |
$0 |
0 |
D |
|
Table II - Derivative Securities Acquired, Disposed of, or
Beneficially Owned (e.g., puts, calls, warrants, options,
convertible securities)
|
1. Title of Derivate Security
(Instr. 3) |
2. Conversion or Exercise Price of Derivative
Security |
3. Trans. Date |
3A. Deemed Execution Date, if any |
4. Trans. Code
(Instr. 8) |
5. Number of Derivative Securities Acquired (A) or
Disposed of (D)
(Instr. 3, 4 and 5) |
6. Date Exercisable and Expiration Date
(MM/DD/YYYY) |
7. Title and Amount of Securities Underlying
Derivative Security
(Instr. 3 and 4) |
8. Price of Derivative Security
(Instr. 5) |
9. Number of Derivative Securities Beneficially
Owned at End of Issuer's Fiscal Year
(Instr. 4) |
10. Ownership Form of Derivative Security: Direct
(D) or Indirect (I)
(Instr. 4) |
11. Nature of Indirect Beneficial Ownership
(Instr. 4) |
|
(A) |
(D) |
Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
| Explanation of
Responses: |
| (1) |
Reflects the transfer of the
reporting person's ownership of Cardinal Holdings Limited
("Cardinal"), an entity which then held the reporting person's
Class A common shares (the "Common Shares") of Athene Holding Ltd.,
to an irrevocable trust for estate planning purposes. In addition,
an agency agreement between Cardinal and the reporting person that
previously allowed the reporting person to retain all voting rights
and dispositive power with respect to shares held at Cardinal was
terminated in early 2021. As a result of these events, the
reporting person no longer beneficially owned these Common Shares
as a result of this transaction. |
| (2) |
Incudes Common Shares that
were previously distributed by AP Alternative Assets, L.P. ("AAA")
on a pro rata basis to unitholders of AAA. |
Remarks:
Exhibit List: Exhibit 24 - Power of Attorney |
Reporting
Owners
|
|
Reporting Owner Name / Address |
Relationships
|
|
Director |
10% Owner |
Officer |
Other |
Lohr Gernot
C/O APOLLO MANAGEMENT, L.P.,
9 W. 57TH STREET, 43RD FLOOR
NEW YORK, NY 10019 |
X |
|
|
|
Signatures
|
|
/s/ Ira Rosenblatt,
attorney-in-fact |
|
2/14/2022 |
| **Signature of Reporting
Person |
Date |
Athene (NYSE:ATH)
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