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* SEQUOIA CAPITAL ISRAEL IV HOLDINGS, L.P. (Last) (First) (Middle) 50 ELI LANDAU BLVD. (Street) HERZELIA L3 4685150 (City) (State) (Zip)	2. Date of Event Requiring Statement (Month/Day/Year) 11/30/2021	3. Issuer Name and Ticker or Trading Symbol Innovid Corp. [ CTV ]
		4. Relationship of Reporting Person(s) to Issuer (Check all applicable) Director X 10% Owner Officer (give title below) Other (specify below)	5. If Amendment, Date of Original Filed (Month/Day/Year)
			6. Individual or Joint/Group Filing (Check Applicable Line) Form filed by One Reporting Person X Form filed by More than One Reporting Person

Table I - Non-Derivative Securities Beneficially Owned
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	17,697,224	I	See Footnote(1)(2)

Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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* SEQUOIA CAPITAL ISRAEL IV HOLDINGS, L.P. (Last) (First) (Middle) 50 ELI LANDAU BLVD. (Street) HERZELIA L3 4685150 (City) (State) (Zip) Relationship of Reporting Person(s) to Issuer Director X 10% Owner Officer (give title below) Other (specify below)

1. Name and Address of Reporting Person* SC ISRAEL IV GENPAR, LTD. (Last) (First) (Middle) 50 ELI LANDAU BLVD. (Street) HERZELIA L3 4685150 (City) (State) (Zip) Relationship of Reporting Person(s) to Issuer Director X 10% Owner Officer (give title below) Other (specify below)

1. Name and Address of Reporting Person* SC ISRAEL IV MANAGEMENT, L.P. (Last) (First) (Middle) 50 ELI LANDAU BLVD. (Street) HERZELIA L3 4685150 (City) (State) (Zip) Relationship of Reporting Person(s) to Issuer Director X 10% Owner Officer (give title below) Other (specify below)

1. Name and Address of Reporting Person* SEQUOIA CAPITAL ISRAEL IV, L.P. (Last) (First) (Middle) 50 ELI LANDAU BLVD. (Street) HERZELIA L3 4685150 (City) (State) (Zip) Relationship of Reporting Person(s) to Issuer Director X 10% Owner Officer (give title below) Other (specify below)

1. Name and Address of Reporting Person* Levy Shmuel (Last) (First) (Middle) 50 ELI LANDAU BLVD (Street) HERZELIA L3 4685150 (City) (State) (Zip) Relationship of Reporting Person(s) to Issuer Director X 10% Owner Officer (give title below) Other (specify below)

1. Name and Address of Reporting Person* SADGER HAIM (Last) (First) (Middle) 50 ELI LANDAU BLVD (Street) HERZELIA L3 4685150 (City) (State) (Zip) Relationship of Reporting Person(s) to Issuer Director X 10% Owner Officer (give title below) Other (specify below)

Explanation of Responses:

1. SC ISRAEL IV GENPAR, LTD is the general partner of SC ISRAEL IV MANAGEMENT, L.P., which is the general partner of SEQUOIA CAPITAL ISRAEL IV L.P., which owns 100% of SEQUOIA CAPITAL ISRAEL IV HOLDINGS, L.P. As such, SC ISRAEL IV GENPAR, LTD shares voting and dispositive power with respect to the shares held by SEQUOIA CAPITAL ISRAEL IV HOLDINGS, L.P. The directors and stockholders of SC ISRAEL IV GENPAR, LTD. who exercise voting and investment discretion with respect to the shares held by SEQUOIA CAPITAL ISRAEL IV HOLDINGS, L.P. are Shmuel Levy and Haim Sadger. As a result, and by virtue of the relationship described in this footnote, each such person may be deemed to share voting and dispositive power with respect to the shares held by the Sequoia Capital Israel IV Holdings, L.P.

2. Each of SC ISRAEL IV GENPAR, LTD, SC ISRAEL IV MANAGEMENT, L.P., SEQUOIA CAPITAL ISRAEL IV L.P., Mr. Levy and Mr. Sadger disclaims beneficial ownership of the shares held by SEQUOIA CAPITAL ISRAEL IV HOLDINGS, L.P. except to the extent of its or his pecuniary interest therein, and the inclusion of these securities in this report shall not be deemed an admission of beneficial ownership of the reported securities for purposes of Section 16 or for any other purposes.

Remarks:

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.

	/s/ By Shmuel Levy, a Director of SC ISRAEL IV GENPAR, LTD	12/10/2021
	/s/ By Shmuel Levy, a Director of SC ISRAEL IV GENPAR, LTD, the general partner of SC ISRAEL IV MANAGEMENT, L.P.	12/10/2021
	/s/ By Shmuel Levy, a Director of SC ISRAEL IV GENPAR, LTD, the general partner of SC ISRAEL IV MANAGEMENT, L.P., the general partner of SEQUOIA CAPITAL ISRAEL IV L.P.	12/10/2021
	/s/ By Shmuel Levy, a Director of SC ISRAEL IV GENPAR, LTD, the general partner of SC ISRAEL IV MANAGEMENT, L.P., the general partner of SEQUOIA CAPITAL ISRAEL IV L.P., which owns 100% of SEQUOIA CAPITAL ISRAEL IV HOLDINGS, L.P	12/10/2021
	/s/ Shmuel Levy	12/10/2021
	/s/ Haim Sadger	12/10/2021
	** 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.