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*
Aggarwal Arjun

(Last) (First) (Middle)
C/O CONVEY HOLDING PARENT, INC.
100 SE THIRD AVENUE, 26TH FLOOR

(Street)
FORT LAUDERDALE FL 33394

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
06/15/2021
3. Issuer Name and Ticker or Trading Symbol
Convey Holding Parent, Inc. [ CNVY ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Mng Partner, HealthScape & EVP
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 ("Common Stock") 569,265 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
Stock Option (right to buy) (1) 03/02/2030 Common Stock 460,608(1) $7.94 D
Stock Option (right to buy) (2) 06/15/2031 Common Stock 17,857(2) $14 D
Restricted Stock Units (3) 06/15/2031 Common Stock 44,643(3) (3) D
Explanation of Responses:
1. Represents (i) 230,304 time-vesting options and (ii) 230,304 performance-vesting options. Time-vesting options are subject to a five-year time-based vesting schedule, with 20% vesting on September 4, 2020 and the remainder vesting in 16 equal installments every three months thereafter. Performance-vesting options vest over a five-year performance period commencing in 2019, with 20% of the stock options eligible to vest each year of the performance period based on achievement of certain financial metrics.
2. Represents 17,857 time-vesting options. Time-vesting options are subject to a four-year time-based vesting schedule, with 25% vesting on June 15, 2022, and the remainder vesting in 12 equal installments every three months thereafter, subject to Mr. Aggarwal's continued service with Convey Holding Parent, Inc. (the "Issuer") through the applicable vesting date.
3. Represents 44,643 restricted stock units. Restricted stock units are subject to a four year time-based vesting schedule with 25% vesting on June 15, 2022, and the remainder vesting in 12 equal installments every three months thereafter, subject to Mr. Aggarwal's continued service with the Issuer through the applicable vesting date. Each restricted stock unit represents a contingent right to receive one share of Issuer common stock. The restricted stock units will be settled in common stock.
Remarks:
Exhibit 24 - Power of Attorney
/s/ Giovanni Castellanos, attorney-in-fact for Arjun Aggarwal 06/15/2021
** 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.
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