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) 10/20/2021 | 3. Issuer Name and Ticker or Trading Symbol Mirion Technologies, Inc. [ MIR ] | |||||||||||||
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) |
Class A Common Stock | 24,746,855 | I | See footnote(1) |
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)
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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. The shares reported herein are held of record by CCP IX LP No. 1, CCP IX LP No. 2, CCP IX Co-investment LP and CCP IX Co-investment No. 2 LP (together, "CCP IX"). Charterhouse General Partners (IX) Ltd is the general partner of each of the limited partnerships comprising CCP IX. CGP IX is managed by a five member board of directors. Each of the CGP IX board members disclaims beneficial ownership of the securities beneficially owned by each of the limited partnerships comprising CCP IX, except to the extent of their pecuniary interest, if any. |
Charterhouse General Partners (IX) Ltd By: /s/ Thomas Patrick, Name: Thomas Patrick, Title: Director | 11/01/2021 | |
CCP IX LP No. 1, acting by its General Partner, Charterhouse General Partners (IX) Ltd By: /s/ Thomas Patrick, Name: Thomas Patrick, Title: Director | 11/01/2021 | |
CCP IX LP No. 2, acting by its General Partner, Charterhouse General Partners (IX) Ltd By: /s/ Thomas Patrick, Name: Thomas Patrick, Title: Director | 11/01/2021 | |
CCP IX Co-investment LP, acting by its General Partner, Charterhouse General Partners (IX) Ltd By: /s/ Thomas Patrick, Name: Thomas Patrick, Title: Director | 11/01/2021 | |
CCP IX Co-investment No. 2 LP, acting by its General Partner, Charterhouse General Partners (IX) Ltd By: /s/ Thomas Patrick, Name: Thomas Patrick, Title: Director | 11/01/2021 | |
** 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. |