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3 Filing
InnovAge Holding (INNV) Form 3Initial statement of insider ownership
Filed: 3 Mar 21, 2:42pm
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) 03/03/2021 | 3. Issuer Name and Ticker or Trading Symbol InnovAge Holding Corp. [ INNV ] | |||||||||||||
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, $0.001 par value | 116,520,612 | I | See Footnote(1)(2)(3) |
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 |
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)
| ||||||||||||
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. Includes 116,520,612 shares of common stock held directly by TCO Group Holdings, L.P. The limited partners of TCO Group Holdings, L.P. may control the voting and dispositive power with respect to the common stock if Ignite Aggregator LP consents to a change to the delegation of authority to the committee of limited partners that controls TCO Group Holding, L.P. Ignite GP, Inc. serves as the general partner of Ignite Aggregator LP. |
2. Ignite Aggregator LP's partnership interests are held by Apax X GP Co. Limited on behalf of Apax X EUR LP, Apax X (Guernsey) USD AIV LP and Apax X USD LP (collectively, the "Apax X Fund"). |
3. Apax X GP Co. Limited, a company incorporated in Guernsey, acts as the investment manager and is responsible for the decision-making on behalf of the Apax X Fund. The directors of Apax X GP Co. Limited are Simon Cresswell, Andrew Guille, Martin Halusa, Paul Meader and David Staples. |
/s/ Andrew Cavanna, President of Ignite GP, Inc., the general partner of Ignite Aggregator LP | 03/03/2021 | |
/s/ Andrew Cavanna, Authorized Signatory of Ignite GP, Inc. | 03/03/2021 | |
/s/ Andrew Guille, Authorized Signatory of Apax X (Guernsey) USD AIV LP | 03/03/2021 | |
/s/ Andrew Guille, Authorized Signatory of Apax X EUR LP | 03/03/2021 | |
/s/ Andrew Guille, Authorized Signatory of Apax X USD LP | 03/03/2021 | |
/s/ Andrew Guille, Authorized Signatory of Apax X GP Co. Limited | 03/03/2021 | |
** 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. |