0000950170-23-070618.txt : 20231215 0000950170-23-070618.hdr.sgml : 20231215 20231215111223 ACCESSION NUMBER: 0000950170-23-070618 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20231212 FILED AS OF DATE: 20231215 DATE AS OF CHANGE: 20231215 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SHAH AJAY CENTRAL INDEX KEY: 0001008036 STATE OF INCORPORATION: CA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-41094 FILM NUMBER: 231489259 MAIL ADDRESS: STREET 1: 2775 SAND HILL ROAD, SUITE 100 CITY: MENLO PARK STATE: CA ZIP: 94025 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Roadzen Inc. CENTRAL INDEX KEY: 0001868640 STANDARD INDUSTRIAL CLASSIFICATION: INSURANCE AGENTS BROKERS & SERVICES [6411] IRS NUMBER: 981600102 STATE OF INCORPORATION: D8 FISCAL YEAR END: 0331 BUSINESS ADDRESS: STREET 1: 111 ANZA BLVD., SUITE 109 CITY: BURLINGAME STATE: CA ZIP: 94010 BUSINESS PHONE: 6504143530 MAIL ADDRESS: STREET 1: 111 ANZA BLVD., SUITE 109 CITY: BURLINGAME STATE: CA ZIP: 94010 FORMER COMPANY: FORMER CONFORMED NAME: Vahanna Tech Edge Acquisition I Corp. DATE OF NAME CHANGE: 20210621 4 1 ownership.xml 4 X0508 4 2023-12-12 0001868640 Roadzen Inc. RDZN 0001008036 SHAH AJAY C/O ROADZEN INC. 111 ANZA BLVD., SUITE 109 BURLINGAME CA 94010 true false false false false Ordinary Shares 2023-12-12 4 P false 5000 3.08 A 477399 I See Footnote Ordinary Shares 2023-12-13 4 P false 10000 3.10 A 487399 I See Footnote The price reported in Column 4 is a weighted average price. These shares were purchased in multiple transactions at prices ranging from $2.96 to $3.09, inclusive. The reporting person undertakes to provide to Roadzen Inc., any security holder of Roadzen Inc., or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares purchased at each separate price within the ranges set forth in footnotes (1) and (3) to this Form 4. The securities are held by Krishnan-Shah Family Partners LP. Ajay B. Shah & Lata K. Shah 1996 Trust LP is the general partner of Krishnan-Shah Family Partners LP (the "General Partner"). Mr. Shah and his wife, Mrs. Lata K. Shah, are the trustees of the General Partner and have voting and dispositive control over the securities held by Krishnan-Shah Family Partners LP. Accordingly, Mr. Shah and Mrs. Shah may be deemed to beneficially own the securities held by Krishnan-Shah Family Partners LP. The price reported in Column 4 is a weighted average price. These shares were purchased in multiple transactions at prices ranging from $2.96 to $3.15, inclusive. Exhibit List Exhibit 24.1 - Power of Attorney /s/ Bruce Goldberg, Attorney-in-Fact 2023-12-14 EX-24 2 rdzn-ex24.htm EX-24 EX-24

Power of Attorney

 

KNOW ALL PERSONS BY THESE PRESENTS, that the undersigned hereby constitutes and appoints each and any of Jean-Noel Gallardo, Bruce Goldberg, Jason T. Simon, Yangyang Jia and Tricia Branker the undersigned’s true and lawful attorney-in-fact and agent, with full power of substitution and re-substitution, for the undersigned and in the undersigned’s name, place and stead, in any and all capacities (until revoked in writing) to:

 

1. Sign any and all instruments, certificates and documents appropriate or required to be executed on behalf of the undersigned pursuant to sections 13 and 16 of the Securities Exchange Act of 1934, as amended (the “Exchange Act”), and any and all regulations promulgated thereunder (including, without limitation, any Joint Filing Agreement with respect thereto), and to file the same, with all exhibits thereto, and any other documents in connection therewith, with the Securities and Exchange Commission (the “SEC”), and with any other entity when and if such is mandated by the Exchange Act or by the Bylaws of the Financial Industry Regulatory Authority;

 

2. prepare, execute, acknowledge, deliver and file a Form ID (including any amendments or authentications thereto) with respect to obtaining EDGAR codes, with the SEC;

 

3. seek or obtain, as the representative of the undersigned and on behalf of the undersigned, information on transactions in securities, from any third party, including brokers, employee benefit plan administrators and trustees, and the undersigned hereby authorizes any such person to release any such information to such attorneys-in-fact and the undersigned approves and ratifies any such release of information; and

 

4. perform any and all other acts which in the discretion of such attorneys-in-fact are necessary or desirable for and on behalf of the undersigned in connection with the foregoing.

 

The undersigned acknowledges that:

 

1. this Power of Attorney authorizes, but does not require, such attorneys-in-fact to act in their discretion on information provided to such attorneys-in-fact without independent verification of such information;

 

2. any documents prepared and/or executed by such attorneys-in-fact on behalf of any of the undersigned pursuant to this Power of Attorney will be in such form and will contain such information and disclosure as such attorney-in-fact, in his or her discretion, deems necessary or desirable;

 

3. the attorneys-in-fact do not assume (a) any liability for responsibility to comply with the requirements of the Exchange Act for any of the undersigned, (b) any liability for any failure to comply with such requirements for any of the undersigned, or (c) any obligation or liability for profit disgorgement under Section 16(b) of the Exchange Act for any of the undersigned; and

 

 

4. this Power of Attorney does not relieve any of the undersigned from responsibility for compliance with the undersigned’s obligations under the Exchange Act, including without limitation the reporting requirements under Sections 13 and 16 of the Exchange Act.

 

The undersigned hereby gives and grants the foregoing attorneys-in-fact full power and authority to do and perform all and every act and thing whatsoever requisite, necessary or appropriate to be done in and about the foregoing matters as fully to all intents and purposes as the undersigned might or could do if present, with full power of substitution and revocation, hereby ratifying all that such attorney-in-fact, or such attorney-in-fact’s substitute or substitutes, of, for and on behalf of the undersigned, shall lawfully do or cause to be done by virtue of this Power of Attorney. This Power of Attorney shall remain in full force and effect until revoked by the undersigned in a signed writing delivered to such attorneys-in-fact.

 

 

 

[Signature page follows]

 

 

 

IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be executed as of this 12/13/2023.

 

/s/ Ajay Shah

 

Name: Ajay Shah

 

 

 

 

[Signature Page to Power of Attorney]