Initial Statement of Beneficial Ownership (3)
24 December 2020 - 8:26AM
Edgar (US Regulatory)
FORM 3
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0104
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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
*
Davis Evan Wainhouse |
2. Date of Event Requiring Statement (MM/DD/YYYY)
12/23/2020
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3. Issuer Name and Ticker or Trading Symbol
Inspired Entertainment, Inc. [INSE]
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(Last)
(First)
(Middle)
15 EAST LEVERING MILL ROAD |
4. 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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(Street)
BALA CYNWYD, PA 19004
(City)
(State)
(Zip)
| 5. 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
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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) |
Common Stock | 6744447 | I | See footnote (1) |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security (Instr. 4) | 2. Date Exercisable and Expiration Date (MM/DD/YYYY) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form of Derivative Security: 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 |
Explanation of Responses: |
(1) | Reflects securities held pursuant to that certain Trust Agreement, dated December 23, 2020 by and between Landgame S.a r.l, a Luxembourg societe a responsabilite limitee, and Evan Davis, as trustee for the Landgame Trust, a grantor trust formed under the laws of the Commonwealth of Pennsylvania (the "Landgame Trust"). The Reporting Person disclaims beneficial ownership of the securities held by the Landgame Trust, except to the extent of his pecuniary interest therein. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Davis Evan Wainhouse 15 EAST LEVERING MILL ROAD BALA CYNWYD, PA 19004 |
| X |
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Signatures
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/s/ Evan Davis | | 12/23/2020 |
**Signature of Reporting Person | Date |
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