SEC Form 3
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) 07/29/2016 | 3. Issuer Name and Ticker or Trading Symbol CardConnect Corp. [ CCN ] | |||||||||||||
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) |
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 |
Explanation of Responses: |
Remarks: |
Each of FTVentures III, L.P. ("FTVIII"), FTVentures III-N, L.P. ("FTVIIIN") and FTVentures III-T, L.P. ("FTVIIIT, together with FTVIII and FTVIIIN, the "FTV Entities") are reporting persons by virtue of its direct beneficial ownership of the issuer's common stock. FTVentures Management III, L.L.C. ("FTVentures") is a reporting person by virtue of if it being the general partner of the FTV Entities. Richard N. Garman, Brad E. Bernstein, David A. Haynes, Chris H. Winship, James C. Hale and Robert A. Huret, are reporting persons by virtue that as the managing members of FTVentures (the "Managing Members"), who acting by a majority vote as a group, share voting and dispositive power over the limited liability company interest in the FTV Entities held directly by FTVentures and share an indirect beneficial interest in the common stock held directly by the FTV Entities. As such, Mr. Garman may be deemed to share beneficial ownership of the shares of the issuer's common stock held of record by the FTV Entities and has an indirect pecuniary interest in such shares through his investment in FTVentures. Mr. Garman expressly disclaims beneficial ownership of such shares except to the extent of his pecuniary interest therein. Exhibit List: Exhibit 24.1 - Power of Attorney |
No securities are beneficially owned. |
Richard N. Garman /s/ David Haynes by Power of Attorney | 08/02/2016 | |
** 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. |