Statement of Changes in Beneficial Ownership (4)
14 October 2020 - 8:29AM
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
|
OMB APPROVAL
OMB Number:
3235-0287
Estimated average burden hours per response...
0.5
|
|
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
|
|
1. Name and Address of Reporting Person
*
Tabak Mark |
2. Issuer Name and Ticker or Trading Symbol
MultiPlan Corp
[
MPLN
]
|
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director _____ 10% Owner __X__ Officer (give title below) _____ Other (specify below) Chief Executive Officer |
(Last)
(First)
(Middle)
C/O MULTIPLAN CORPORATION, 115 FIFTH AVENUE |
3. Date of Earliest Transaction
(MM/DD/YYYY)
10/8/2020 |
(Street)
NEW YORK, NY 10003
(City)
(State)
(Zip)
|
4. 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
|
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
|
1.Title of Security (Instr. 3)
|
2. Trans. Date
|
2A. Deemed Execution Date, if any
|
3. Trans. Code (Instr. 8)
|
4. Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)
|
5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4)
|
6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
|
7. Nature of Indirect Beneficial Ownership (Instr. 4)
|
Code
|
V
|
Amount
|
(A) or (D)
|
Price
|
Class A common stock | 10/8/2020 | | A(1) | | 5023609 | A | (1) | 5023609 | D | |
Class A common stock | 10/8/2020 | | A(1) | | 4433296 | A | (1) | 4433296 | I | See Footnote (2) |
Class A common stock | 10/8/2020 | | A(1) | | 4433296 | A | (1) | 4433296 | I | See Footnote (3) |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
|
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) | Reflects shares of Class A common stock of the Issuer ("Common Stock") received pursuant to an Agreement and Plan of Merger, dated July 12, 2020 (the "Merger Agreement"), by and among the Issuer (formerly known as Churchill Capital Corp III), Polaris Parent Corp. ("MultiPlan Parent"), Polaris Investment Holdings, L.P., Music Merger Sub I, Inc. and Music Merger Sub II LLC, pursuant to which Music Merger Sub I, Inc. merged with MultiPlan Parent, with MultiPlan Parent surviving, and MultiPlan Parent merged with and into Music Merger Sub II LLC, with Music Merger Sub II LLC surviving the merger as a wholly owned subsidiary of the Issuer (which changed its name to MultiPlan Corporation). Pursuant to the Merger Agreement, former stockholders of MultiPlan Parent received their pro rata portion of the merger consideration, which was equal to $5,678,000,000, paid in a combination of $1,521,000,000 cash with the remainder paid in shares of Common Stock in an amount equal to $10.00 per share. |
(2) | Reflects securities directly held by the Lauren Fass 2012 Dynasty Trust, dated July 11, 2012, of which Mr. Tabak's spouse is the trustee. |
(3) | Reflects securities directly held the Lindsay Levin 2012 Dynasty Trust, dated July 11, 2012, of which Mr. Tabak's spouse is the trustee. |
Reporting Owners
|
Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Tabak Mark C/O MULTIPLAN CORPORATION 115 FIFTH AVENUE NEW YORK, NY 10003 | X |
| Chief Executive Officer |
|
Signatures
|
/s/ Jeffrey Doctoroff, attorney-in-fact | | 10/13/2020 |
**Signature of Reporting Person | Date |
Churchill Capital Corp III (NYSE:MPLN)
Historical Stock Chart
From Apr 2024 to May 2024
Churchill Capital Corp III (NYSE:MPLN)
Historical Stock Chart
From May 2023 to May 2024