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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 | ||||||||
Class B Common Stock | (1) | 06/30/2020 | J(1) | 18,750 | (2) | (2) | Class A Common Stock | 18,750 | $ 0 | 8,750,000 | D (3) |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Fusion Sponsor LLC C/O FUSION ACQUISITION CORP. 375 PARK AVENUE, SUITE 2607 NEW YORK, NY 10152 |
X | X | ||
James John C/O FUSION ACQUISITION CORP 375 PARK AVENUE, SUITE 2607 NEW YORK, NY 10152 |
X | X | Chief Executive Officer |
/s/ Sarah Ross, Attorney-in-Fact for Fusion Sponsor LLC | 06/30/2020 | |
**Signature of Reporting Person | Date | |
/s/ Sarah Ross, Attorney-in-Fact for John James | 06/30/2020 | |
**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) | On June 30, 2020, Fusion Sponsor LLC forfeited at no cost 18,750 shares of Class B common stock of the Issuer in connection with the election by the underwriters of the Issuer's initial public offering of units to exercise an option granted to them to cover over-allotments in part and not in full. |
(2) | The shares of Class B common stock are convertible for shares of the Issuer's Class A common stock as described under the heading "Description of Securities" in the Issuer's Registration Statement on Form S-1 (File No. 333-239023) (the "Registration Statement") and have no expiration date. |
(3) | Fusion Sponsor LLC is the record holder of the securities reported herein. John James is the managing member of Fusion Sponsor. Mr. James has voting and investment discretion with respect to the securities held of record by Fusion Sponsor LLC. |