0000899243-21-010413.txt : 20210308
0000899243-21-010413.hdr.sgml : 20210308
20210308171820
ACCESSION NUMBER: 0000899243-21-010413
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210308
FILED AS OF DATE: 20210308
DATE AS OF CHANGE: 20210308
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: SAVAGE ROBERT F JR
CENTRAL INDEX KEY: 0001198067
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39602
FILM NUMBER: 21722951
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: KELTER JEFFREY E
CENTRAL INDEX KEY: 0001198068
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39602
FILM NUMBER: 21722952
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: KSH Capital LP
CENTRAL INDEX KEY: 0001827310
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39602
FILM NUMBER: 21722953
BUSINESS ADDRESS:
STREET 1: 386 PARK AVENUE SOUTH, FL 20
CITY: NEW YORK
STATE: NY
ZIP: 10016
BUSINESS PHONE: 212-710-5060
MAIL ADDRESS:
STREET 1: 386 PARK AVENUE SOUTH, FL 20
CITY: NEW YORK
STATE: NY
ZIP: 10016
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: JCIC Sponsor LLC
CENTRAL INDEX KEY: 0001822261
STATE OF INCORPORATION: E9
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39602
FILM NUMBER: 21722954
BUSINESS ADDRESS:
STREET 1: 386 PARK AVENUE SOUTH, FL 20
CITY: NEW YORK
STATE: NY
ZIP: 10016
BUSINESS PHONE: 212-710-5060
MAIL ADDRESS:
STREET 1: 386 PARK AVENUE SOUTH, FL 20
CITY: NEW YORK
STATE: NY
ZIP: 10016
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: JERMOLUK THOMAS
CENTRAL INDEX KEY: 0001823753
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39602
FILM NUMBER: 21722950
MAIL ADDRESS:
STREET 1: 386 PARK AVENUE SOUTH, FL 20
CITY: NEW YORK
STATE: NY
ZIP: 10016
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Jack Creek Investment Corp.
CENTRAL INDEX KEY: 0001822312
STANDARD INDUSTRIAL CLASSIFICATION: BLANK CHECKS [6770]
IRS NUMBER: 000000000
STATE OF INCORPORATION: E9
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 386 PARK AVENUE SOUTH, FL 20
CITY: NEW YORK
STATE: NY
ZIP: 10016
BUSINESS PHONE: 212-710-5060
MAIL ADDRESS:
STREET 1: 386 PARK AVENUE SOUTH, FL 20
CITY: NEW YORK
STATE: NY
ZIP: 10016
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2021-03-08
0
0001822312
Jack Creek Investment Corp.
JCIC
0001822261
JCIC Sponsor LLC
C/O JACK CREEK INVESTMENT CORP.,
386 PARK AVENUE SOUTH, FL 20
NEW YORK
NY
10016
0
0
1
0
0001827310
KSH Capital LP
C/O JACK CREEK INVESTMENT CORP.,
386 PARK AVENUE SOUTH, FL 20
NEW YORK
NY
10016
0
0
0
1
Manager
0001198068
KELTER JEFFREY E
C/O JACK CREEK INVESTMENT CORP.,
386 PARK AVENUE SOUTH, FL 20
NEW YORK
NY
10016
1
0
0
0
0001198067
SAVAGE ROBERT F JR
C/O JACK CREEK INVESTMENT CORP.,
386 PARK AVENUE SOUTH, FL 20
NEW YORK
NY
10016
0
1
0
0
Chief Executive Officer
0001823753
JERMOLUK THOMAS
C/O JACK CREEK INVESTMENT CORP.,
386 PARK AVENUE SOUTH, FL 20
NEW YORK
NY
10016
1
0
0
0
Class B Ordinary Shares, par value $0.0001 per share
2021-03-08
4
S
0
25000
0.0029
D
Class A Ordinary Shares, par value $0.0001 per share
25000
8550000
I
See footnotes
This form is being filed by the following Reporting Persons: JCIC Sponsor LLC (the "Sponsor"), KSH Capital LP ("KSH Capital"), Jeffrey E. Kelter, Robert F. Savage and Thomas Jermoluk. Because of the relationships among the Reporting Persons, the Reporting Persons may be deemed to beneficially own the securities reported herein to the extent of their respective pecuniary interests. Each Reporting Person disclaims beneficial ownership of the securities reported herein, except to the extent of such Reporting Person's pecuniary interest therein, if any.
Sponsor sold 25,000 shares of Class B ordinary shares, par value $0.0001 per share (the "Class B Ordinary Shares") for the aggregate consideration of $72.46. Class B Ordinary Shares have no expiration date and are convertible into Class A ordinary shares, par value $0.0001 per share, of the Issuer, as described under the heading "Description of Securities-founder shares" in the Issuer's registration statement on Form S-1 (File No. 333-248951).
The manager of the Sponsor is KSH Capital. Each of Jeffrey E. Kelter, Robert F. Savage and Thomas Jermoluk indirectly own an approximately 30% interest in Sponsor and, pursuant to the Sponsor's operating agreement, through their investment vehicles have a consent right over the Sponsor's investments, including voting and investment discretion with respect to the Class B Ordinary Shares held of record by the Sponsor.
Pursuant to Rule 16a-1(a)(4) under the Exchange Act, this filing shall not be deemed an admission that the Reporting Persons are, for purposes of Section 16 of the Exchange Act or otherwise, the beneficial owners of any equity securities in excess of their respective pecuniary interests.
/s/ Robert Savage, JCIC Sponsor LLC, By its Manager, KSH CAPITAL LP, Acting by its General Partner, KSH CAPITAL GP LLC, Robert Savage, President
2021-03-08
* KSH Capital LP
2021-03-08
* Jeffrey E. Kelter
2021-03-08
* Robert F. Savage
2021-03-08
* Thomas Jermoluk
2021-03-08
*By: /s/ Lauren Ores, Attorney-in-Fact
2021-03-08