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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES 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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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. | SEC 1474 (9-02) |
1. Title of Derivative Security (Instr. 3) |
2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction 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 (Month/Day/Year) |
7. Title and Amount of Underlying Securities (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) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
KRAUSS MARLENE 30 PARK PLACE, SUITE 64B NEW YORK, NY 10007 |
X | |||
KBL IV SPONSOR LLC 30 PARK PLACE, SUITE 64B NEW YORK, NY 10007 |
X |
/s/ Marlene Krauss, M.D. | 12/17/2020 | |
**Signature of Reporting Person | Date | |
/s/ Marlene Krauss, M.D., as Managing Member of KBL IV SPONSOR LLC | 12/17/2020 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 4(b)(v). |
** | Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
(1) | The securities are held directly by KBL IV Sponsor LLC ("KBL Sponsor"). Dr. Marlene Krauss, the former Chief Executive Officer, and a former member of the Board of Directors, of the issuer, is the sole managing member of KBL Sponsor. Consequently, she may be deemed the beneficial owner of the securities of the issuer held by KBL Sponsor, and she has sole voting and dispositive control over such securities. Dr. Krauss disclaims beneficial ownership over any securities of the issuer owned by KBL Sponsor in which she does not have a pecuniary interest. |
(2) | KBL Sponsor made a pro rata distribution for no consideration of an aggregate of 520,312 shares of the common stock of the issuer to its members on December 16, 2020. |
(3) | Represents 334,608 shares of the issuer's common stock that were received by Dr. Krauss in a pro rata distribution made by KBL Sponsor to its members on December 16, 2020. In prior reports, Dr. Krauss reported indirect beneficial ownership of all of the shares of the issuer's common stock held by KBL Sponsor. |