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3 Filing
LegalZoom.com (LZ) Form 3LEGALZOOM.COM / Sarl Lucazoom ownership change
Filed: 29 Jun 21, 6:21pm
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)
| 2. Date of Event Requiring Statement (Month/Day/Year) 06/29/2021 | 3. Issuer Name and Ticker or Trading Symbol LEGALZOOM.COM, INC. [ LZ ] | |||||||||||||
4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
| 5. If Amendment, Date of Original Filed (Month/Day/Year) | ||||||||||||||
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) |
Common Stock | 1,475,300 | D(1)(2) |
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 | ||||
Series A Redeemable Convertible Preferred Stock | (3) | (3) | Common Stock | 36,537,688 | (3) | D(1)(2) |
1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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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. As of the date hereof, LucasZoom, LLC owns 1,475,300 shares of common stock and 18,268,844 shares of Series A redeemable convertible preferred stock of the Issuer (the "Subject Securities"). Lucazoom S.a.r.l. ("Lucazoom") is the sole member of LucasZoom, LLC. Permira V L.P.2 ("Permira V") is the controlling shareholder of Lucazoom. Permira V GP L.P. ("Permira V GP") is the general partner of Permira V. Permira V GP Limited (together with Lucazoom, Permira V and Permira V GP, the "Permira Entities") is the general partner of Permira V GP. |
2. The Permira Entities may be deemed to share voting and dispositive power over the Subject Securities held by LucasZoom, LLC but disclaim such beneficial ownership except to the extent of their pecuniary interest therein. |
3. Each share of the Issuer's Series A redeemable convertible preferred stock is convertible at any time into two shares of the Issuer's common stock at the option of the holder, and will automatically convert into shares of the Issuer's common stock on a one-for-two basis upon completion of the Issuer's initial public offering and concurrent private placement. |
Remarks: |
Dipan Patel and Brian Ruder currently serve on the board of directors of the Issuer as the Reporting Persons' representatives, and therefore the Reporting Persons may be deemed a "director by deputization" of the Issuer. |
/s/ Brian Ruder By: Brian Ruder, President, Chief Executive Officer and Secretary, LucasZoom, LLC | 06/29/2021 | |
/s/ Severine Michel By: Severine Michel, Manager, Lucazoom S.a.r.l. | 06/29/2021 | |
/s/ Julie Preece By: Julie Preece, Director for Permira V GP Limited, general partner of Permira V GP L.P., general partner of Permira V L.P.2 | 06/29/2021 | |
/s/ Julie Preece By: Julie Preece, Director for Permira V GP Limited, general partner of Permira V GP L.P. | 06/29/2021 | |
/s/ Julie Preece By: Julie Preece, Director for Permira V GP Limited | 06/29/2021 | |
** 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. |