SEC Form 3: New insider Icahn School Of Medicine At Mount Sinai claimed ownership of 88,355,473 shares
$CMLF
Business Services
Finance
| FORM 3 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 INITIAL STATEMENT OF 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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1. Name and Address of Reporting Person*
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 07/22/2021 |
3. Issuer Name and Ticker or Trading Symbol
Sema4 Holdings Corp. [ SMFR ] |
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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5. If Amendment, Date of Original Filed
(Month/Day/Year) |
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6. Individual or Joint/Group Filing (Check Applicable Line)
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| Table I - Non-Derivative Securities Beneficially Owned | |||
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| 1. Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
| Class A Common Stock | 88,355,473 | D(1) | |
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Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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| 1. Title of Derivative Security (Instr. 4) | 2. Date Exercisable and Expiration Date (Month/Day/Year) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 6. Nature of Indirect Beneficial Ownership (Instr. 5) | ||
| Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
| Earn-out Shares(2) | (3) | (4) | Class A Common Stock | 11,597,198(5) | 0.00 | D | |
1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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| Explanation of Responses: |
| 1. The securities reported herein are held directly by the Reporting Person. As its sole member, Mount Sinai Health System, Inc., a NY not-for-profit corporation ("MSHS"), may be deemed to beneficially own securities owned by the Reporting Person; however, MSHS does not have voting or investment power over such securities and disclaims beneficial interest therein except to the extent of its pecuniary interest, if any. |
| 2. Shares of Issuer's Class A common stock that may be issued upon the occurrence of certain triggering events pursuant to the earn-out provisions of that certain Agreement and Plan of Merger, dated February 9, 2021 (the "Merger Agreement"), by and among CM Life Sciences, Inc., S-IV Sub, Inc., and Mount Sinai Genomics, Inc. d/b/a Sema4 (the "Earn Out Shares"). |
| 3. See footnote 2. |
| 4. Not applicable. |
| 5. Maximum number of shares of Class A common stock of Issuer that may be issued to Reporting Person pursuant to the Merger Agreement as a result of the occurrence of certain triggering events set forth therein. |
| Remarks: |
| /s/ Stephen Harvey | 10/07/2021 | |
| /s/ Stephen Harvey | 10/07/2021 | |
| ** Signature of Reporting Person | Date | |
| Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | ||
| * If the form is filed by more than one reporting person, see Instruction 5 (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). | ||
| Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
| 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 Number. | ||