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*
Johnson Mairi

(Last) (First) (Middle)
2500 BEE CAVE ROAD
BLDG. 1, SUITE 400

(Street)
AUSTIN TX 78746

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
01/01/2023
3. Issuer Name and Ticker or Trading Symbol
Babylon Holdings Ltd [ BBLN ]
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)
Class A ordinary shares 503 D
Class A ordinary shares (earnout shares) 1,552,000(1) I By Spouse indirectly through ALP Partners Limited
Class A ordinary shares 4,693,983 I By Spouse indirectly through ALP Partners Limited
Class A ordinary shares 160,000 I By Spouse
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
Restricted share units (2) (2) Class A ordinary shares 2,088 (3) D
Performance share units (4) (4) Class A ordinary shares 160,000 (3) I By Spouse
Explanation of Responses:
1. The earnout shares are subject to transfer restrictions which are to be released in four equal portions subject to achieving milestones on the trading price of the Class A ordinary shares on the NYSE of $312.50, $375, $437.50 and $500, within and for specified time periods. If the milestones are not met, all of the earnout shares for which the applicable milestone has not been met will be automatically converted into redeemable shares which the issuer can redeem for $1.00.
2. The restricted share units ("RSUs") were awarded under the Babylon Holdings Limited 2021 Equity Incentive Plan (the "2021 Plan") and are made up of three separate awards. The first award for 497 Class A ordinary shares vests on March 14, 2025. The second award for 1,360 Class A ordinary shares vests in equal quarterly installments beginning February 1, 2023. The third award for 231 Class A ordinary shares vests in equal quarterly installments beginning March 14, 2023. Vested RSUs will be settled in shares or cash as soon as administratively practicable after vesting, but in no event more than 60 days after the RSUs' vesting date.
3. Each RSU and PSU represents a contingent right to receive one Class A ordinary share.
4. The performance share units ("PSUs") were awarded under the 2021 Plan and vest in three tranches consisting of 50%, 25% and 25% of the PSUs. Each such tranche of PSUs vests upon the earlier of the date on which the issuer's (i) Class A ordinary shares achieve a specified price per share or (ii) market capitalization in respect of its Class A ordinary shares meets a specified dollar threshold. Vested PSUs will be settled in shares or cash as soon as administratively practicable after vesting, but in no event more than 60 days after the PSUs' vesting date.
Remarks:
/s/ Mairi Johnson 01/10/2023
** 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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