Statement of Changes in Beneficial Ownership (4)
10 September 2021 - 10:57PM
Edgar (US Regulatory)
FORM 4
[ ]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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3235-0287
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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
*
Hebert Peter |
2. Issuer Name and Ticker or Trading Symbol
Aeva Technologies, Inc.
[
AEVA
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director __X__ 10% Owner _____ Officer (give title below) _____ Other (specify below)
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(Last)
(First)
(Middle)
920 BROADWAY, 11TH FLOOR |
3. Date of Earliest Transaction
(MM/DD/YYYY)
9/8/2021 |
(Street)
NEW YORK, NY 10010
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
___ Form filed by One Reporting Person
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X
_ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security (Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code (Instr. 8)
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4. Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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Common Stock | 9/8/2021 | | J(1) | | 7346159 | D | $0 | 22038475 | I | See Footnote (1) |
Common Stock | | | | | | | | 1959371 | I | See Footnote (2) |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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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 | 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 Following Reported Transaction(s) (Instr. 4) | 10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) |
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Explanation of Responses: |
(1) | Pro rata distribution from Lux Ventures IV, L.P. to its partners. Lux Venture Partners IV, LLC is the general partner of Lux Ventures IV, L.P. and exercises voting and dispositive power over the shares noted herein held by Lux Ventures IV, L.P. Peter Hebert and Josh Wolfe are the individual managing members of Lux Venture Partners IV, LLC (the "Individual Lux Managers"). The Individual Lux Managers, as the sole managers of Lux Venture Partners IV, LLC, may be deemed to share voting and dispositive power for the shares noted herein held by Lux Ventures IV, L.P. Each of Lux Venture Partners IV, LLC and the Individual Lux Managers separately disclaim beneficial ownership over the shares noted herein except to the extent of their pecuniary interest therein. |
(2) | These shares are owned directly by Lux Co-Invest Opportunities, L.P. Lux Co-Invest Partners, LLC is the general partner of Lux Co-Invest Opportunities, L.P. and exercises voting and dispositive power over the shares noted herein held by Lux Co-Invest Opportunities, L.P. The Individual Lux Managers are the individual managing members of Lux Co-Invest Partners, LLC. The Individual Lux Managers, as the sole managers of Lux Co-Invest Partners, LLC, may be deemed to share voting and dispositive power for the shares noted herein held by Lux Co-Invest Opportunities, L.P. Each of Lux Co-Invest Partners, LLC and the Individual Lux Managers separately disclaim beneficial ownership over the shares noted herein except to the extent of their pecuniary interest. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Hebert Peter 920 BROADWAY, 11TH FLOOR NEW YORK, NY 10010 |
| X |
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Wolfe Josh 920 BROADWAY, 11TH FLOOR NEW YORK, NY 10010 |
| X |
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Lux Ventures IV, L.P. 920 BROADWAY, 11TH FLOOR NEW YORK, NY 10010 |
| X |
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Lux Co-Invest Opportunities, L.P. 920 BROADWAY, 11TH FLOOR NEW YORK, NY 10010 |
| X |
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Lux Venture Partners IV, LLC 920 BROADWAY, 11TH FLOOR NEW YORK, NY 10010 |
| X |
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Lux Co-Invest Partners, LLC 920 BROADWAY, 11TH FLOOR NEW YORK, NY 10010 |
| X |
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Signatures
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/s/ Segolene Scarborough, Segolene Scarborough, Attorney-in-Fact for Peter Hebert | | 9/10/2021 |
**Signature of Reporting Person | Date |
/s/ Segolene Scarborough, Segolene Scarborough, Attorney-in-Fact for Josh Wolfe | | 9/10/2021 |
**Signature of Reporting Person | Date |
LUX VENTURE PARTNERS IV, LLC, /s/ Segolene Scarborough, Segolene Scarborough, Attorney-in-Fact for Peter Hebert, Managing Member | | 9/10/2021 |
**Signature of Reporting Person | Date |
LUX VENTURES IV, L.P., By: Lux Venture Partners IV, LLC, Its: General Partner, /s/ Segolene Scarborough, Segolene Scarborough, Attorney-in-Fact for Peter Hebert, Managing Member | | 9/10/2021 |
**Signature of Reporting Person | Date |
LUX CO-INVEST PARTNERS, LLC, /s/ Segolene Scarborough, Segolene Scarborough, Attorney-in-Fact for Peter Hebert, Managing | | 9/10/2021 |
**Signature of Reporting Person | Date |
LUX CO-INVEST OPPORTUNITIES, L.P., By: Lux Co-Invest Partners, LLC, Its: General Partner, /s/ Segolene Scarborough, Segolene Scarborough, Attorney-in-Fact for Peter Hebert, Managing Member | | 9/10/2021 |
**Signature of Reporting Person | Date |
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