0001140361-19-014778.txt : 20190809 0001140361-19-014778.hdr.sgml : 20190809 20190809172413 ACCESSION NUMBER: 0001140361-19-014778 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190807 FILED AS OF DATE: 20190809 DATE AS OF CHANGE: 20190809 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Flowers J. Christopher CENTRAL INDEX KEY: 0001041196 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38945 FILM NUMBER: 191013918 MAIL ADDRESS: STREET 1: 717 FIFTH AVENUE STREET 2: 26TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10022 FORMER NAME: FORMER CONFORMED NAME: FLOWERS CHRISTOPHER J DATE OF NAME CHANGE: 19970618 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: JCF Associates IV Ltd. CENTRAL INDEX KEY: 0001783442 STATE OF INCORPORATION: E9 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38945 FILM NUMBER: 191013919 BUSINESS ADDRESS: STREET 1: C/O J.C. FLOWERS & CO. LLC STREET 2: 767 FIFTH AVENUE, 23RD FLOOR CITY: NEW YORK STATE: NY ZIP: 10153 BUSINESS PHONE: 212-404-6810 MAIL ADDRESS: STREET 1: C/O J.C. FLOWERS & CO. LLC STREET 2: 767 FIFTH AVENUE, 23RD FLOOR CITY: NEW YORK STATE: NY ZIP: 10153 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: JCF Associates IV L.P. CENTRAL INDEX KEY: 0001783458 STATE OF INCORPORATION: E9 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38945 FILM NUMBER: 191013920 BUSINESS ADDRESS: STREET 1: C/O J.C. FLOWERS & CO. LLC STREET 2: 767 FIFTH AVENUE, 23RD FLOOR CITY: NEW YORK STATE: NY ZIP: 10153 BUSINESS PHONE: 212-404-6810 MAIL ADDRESS: STREET 1: C/O J.C. FLOWERS & CO. LLC STREET 2: 767 FIFTH AVENUE, 23RD FLOOR CITY: NEW YORK STATE: NY ZIP: 10153 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Apex Holdco GP LLC CENTRAL INDEX KEY: 0001783535 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38945 FILM NUMBER: 191013921 BUSINESS ADDRESS: STREET 1: C/O J.C. FLOWERS & CO. LLC STREET 2: 767 FIFTH AVENUE, 23RD FLOOR CITY: NEW YORK STATE: NY ZIP: 10153 BUSINESS PHONE: 212-404-6810 MAIL ADDRESS: STREET 1: C/O J.C. FLOWERS & CO. LLC STREET 2: 767 FIFTH AVENUE, 23RD FLOOR CITY: NEW YORK STATE: NY ZIP: 10153 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Apex Holdco L.P. CENTRAL INDEX KEY: 0001783445 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38945 FILM NUMBER: 191013922 BUSINESS ADDRESS: STREET 1: C/O J.C. FLOWERS & CO. LLC STREET 2: 767 FIFTH AVENUE, 23RD FLOOR CITY: NEW YORK STATE: NY ZIP: 10153 BUSINESS PHONE: 212-404-6810 MAIL ADDRESS: STREET 1: C/O J.C. FLOWERS & CO. LLC STREET 2: 767 FIFTH AVENUE, 23RD FLOOR CITY: NEW YORK STATE: NY ZIP: 10153 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Vericity, Inc. CENTRAL INDEX KEY: 0001575434 STANDARD INDUSTRIAL CLASSIFICATION: LIFE INSURANCE [6311] IRS NUMBER: 462348863 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 8700 W. BRYN MAWR AVE. STREET 2: SUITE 900S CITY: CHICAGO STATE: IL ZIP: 60631 BUSINESS PHONE: 800-369-3990 MAIL ADDRESS: STREET 1: 8700 W. BRYN MAWR AVE. STREET 2: SUITE 900S CITY: CHICAGO STATE: IL ZIP: 60631 3 1 form3.xml FORM 3 X0206 3 2019-08-07 0 0001575434 Vericity, Inc. VERY 0001783445 Apex Holdco L.P. 767 5TH AVE, 23RD FLOOR NEW YORK NY 10153 true 0001783535 Apex Holdco GP LLC C/O J.C. FLOWERS & CO. LLC 767 FIFTH AVENUE, 23RD FLOOR NEW YORK NY 10153 true 0001783458 JCF Associates IV L.P. C/O J.C. FLOWERS & CO. LLC 767 FIFTH AVENUE, 23RD FLOOR NEW YORK NY 10153 true 0001783442 JCF Associates IV Ltd. C/O J.C. FLOWERS & CO. LLC 767 FIFTH AVENUE, 23RD FLOOR NEW YORK NY 10153 true 0001041196 Flowers J. Christopher 717 FIFTH AVENUE 26TH FLOOR NEW YORK NY 10022 true Common Stock 11373352 D Apex Holdco L.P. By: /s/Todd Freebern 2019-08-07 Apex Holdco GP LLC By: /s/ Eric Rahe Name: Eric Rahe Title: Vice President 2019-08-07 JCF Associates IV L.P. By: /s/ J. Christopher Flowers Name: J. Christopher Flowers Title: Director 2019-08-07 JCF Associates IV Ltd. By: /s/ J. Christopher Flowers Name: J. Christopher Flowers Title: Director 2019-08-07 /s/ J. Christopher Flowers 2019-08-07