Statement of Changes in Beneficial Ownership (4)
06 Dezember 2021 - 10:31PM
Edgar (US Regulatory)
FORM 4
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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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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
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KAUFFMAN ROBERT I |
2. Issuer Name and Ticker or Trading Symbol
Hagerty, Inc.
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HGTY
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director _____ 10% Owner _____ Officer (give title below) _____ Other (specify below)
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(Last)
(First)
(Middle)
105 S. MAPLE STREET |
3. Date of Earliest Transaction
(MM/DD/YYYY)
12/2/2021 |
(Street)
ITASCA, IL 60143
(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)
_X
_ Form filed by One Reporting Person
___ 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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Class A Common Stock | 12/2/2021 | | J(1) | | 2000000 | A | $0 | 2000000 | I | Held by Aldel LLC (2) |
Class A Common Stock | 12/2/2021 | | M(3) | | 2225000 (4) | A | $0 | 2225000 | D | |
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 |
Class B Common Stock | (3) | 12/2/2021 | | M (3) | | | 2225000 | (3) | (3) | Class A Common Stock | 2225000 (4) | $0 | 0 | D | |
Explanation of Responses: |
(1) | Consists of 2,000,000 shares of Class A Common Stock purchased in a private placement from Aldel Financial Inc. (the "PIPE Financing") by Aldel LLC for $10.00 per share. |
(2) | Held by Aldel LLC. Mr. Kauffman is the managing member of Aldel LLC and has voting and investment power over the shares of Class A Common Stock held by Aldel LLC. |
(3) | As described in Aldel Financial Inc.'s definitive proxy statement dated November 10, 2021 under the heading "Description of Securities of Aldel- Founder Shares," the shares of Class B common stock of the Issuer were automatically converted into shares of Class A common stock at the time of the registrant's initial business combination on a one-for-one basis. |
(4) | Includes 2,200,000 shares held by Aldel Investors LLC. Mr. Kauffman is the manager of Aldel Investors LLC and has voting and investment power over the shares of Class A Common Stock held by Aldel Investors LLC. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
KAUFFMAN ROBERT I 105 S. MAPLE STREET ITASCA, IL 60143 | X |
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Signatures
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/s/ Barbara E. Matthews, Power of Attorney | | 12/6/2021 |
**Signature of Reporting Person | Date |
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