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*
Weldon Raymond F

(Last) (First) (Middle)
C/O SELECTQUOTE, INC.
6800 WEST 115TH STREET, SUITE 2511

(Street)
OVERLAND PARK KS 66211

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
05/20/2020
3. Issuer Name and Ticker or Trading Symbol
SelectQuote, Inc. [ SLQT ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 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)
X Form filed by One Reporting Person
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, par value $0.01 per share 40,000(1) D
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
Series D Convertible Preferred Stock 07/23/2014 (2) Common Stock, par value $0.01 per share 15,470,824(5) (2) I Owned by BEP III LLC
Series D Convertible Preferred Stock 07/23/2014 (3) Common Stock, par value $0.01 per share 12,044,344(5) (3) I Owned by BEP III Co-Invest LLC
Series D Convertible Preferred Stock 07/23/2014 (4) Common Stock, par value $0.01 per share 3,292,320(5) (4) I Owned by SQ Co-investors LLC
Explanation of Responses:
1. Includes 40,000 shares of common stock held directly by Mr. Weldon and his spouse Lea Weldon.
2. BEP III LLC has the right to acquire 15,470,824 shares of common stock upon the conversion of 1,933,853 shares of Series D Convertible Preferred Stock at a conversion rate of eight shares of common stock for every one share of Series D Convertible Preferred Stock. Such conversion may be effected at any time while such preferred shares are outstanding. Each outstanding share of Series D Convertible Preferred Stock will automatically convert into eight shares of common stock for no additional consideration upon the closing of SelectQuote Inc.'s initial public offering.
3. BEP III Co-Invest LLC has the right to acquire 12,044,344 shares of common stock upon the conversion of 1,505,543 shares of Series D Convertible Preferred Stock at a conversion rate of eight shares of common stock for every one share of Series D Convertible Preferred Stock. Such conversion may be effected at any time while such preferred shares are outstanding. Each outstanding share of Series D Convertible Preferred Stock will automatically convert into eight shares of common stock for no additional consideration upon the closing of SelectQuote Inc.'s initial public offering.
4. SQ Co-investors LLC has the right to acquire 3,292,320 shares of common stock upon the conversion of 411,540 shares of Series D Convertible Preferred Stock at a conversion rate of eight shares of common stock for every one share of Series D Convertible Preferred Stock. Such conversion may be effected at any time while such preferred shares are outstanding. Each outstanding share of Series D Convertible Preferred Stock will automatically convert into eight shares of common stock for no additional consideration upon the closing of SelectQuote Inc.'s initial public offering.
5. Mr. Weldon owns an indirect pecuniary interest in the securities reported on this line. Mr. Weldon disclaims beneficial ownership of the securities reported on this line except to the extent of his pecuniary interest therein.
Remarks:
/s/ Raymond F. Weldon 05/20/2020
** 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.
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