SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

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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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
Chu Chinh

(Last) (First) (Middle)
STERLING HOUSE
16 WESLEY STREET

(Street)
HAMILTON HM CX D0

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
FGL Holdings [ FG ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
X Officer (give title below) Other (specify below)
Co-Executive Chairman
3. Date of Earliest Transaction (Month/Day/Year)
11/29/2017
4. 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 Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Ordinary Shares(1) 11/30/2017 C 11,090,390 A (2) 11,090,390 I See Footnote(3)
Ordinary Shares 11/30/2017 A(4) 2,750,000 A $10 13,840,390 I See Footnote(3)
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Class B Ordinary Shares (2) 11/29/2017 J(5) 30,221 (2) (2) Ordinary Shares (2) (5) 4,788,080(5) I See Footnote(3)
Class B Ordinary Shares (2) 11/30/2017 C 4,788,080 (2) (2) Ordinary Shares (2) (2) 0 I See Footnote(3)
Private Placement Warrants $11.5 11/29/2017 A(6) 1,500,000 12/30/2017 11/30/2022 Ordinary Shares 1,500,000 $1 17,300,000 I See Footnote(3)
Private Placement Warrants $11.5 11/30/2017 A(4) 916,667 12/30/2017 11/30/2022 Ordinary Shares 916,667 (4) 9,566,667(5) I See Footnote(3)
Explanation of Responses:
1. Pursuant to a reclassification exemption under Rule 16b-7, the Issuer re-designated each Class A Ordinary Share (par value $0.0001 per share) as Ordinary Shares (par value $0.0001 per share) on November 30, 2017. Therefore, for purposes of this filing, all Class A Ordinary Shares are referred herein as Ordinary Shares.
2. The Class B Ordinary Shares are convertible, as described under the heading "Conversion of Founder Shares" in the CF Corporation's (CF Corporation is a predecessor entity to the Issuer) Schedule 14A (File No. 333-210854) and have no expiration date.
3. Effective on or after November 29, 2017, all Ordinary Shares, Class B Ordinary Shares and Private Placement Warrants ("PPWs") are held by CC Capital Management, LLC ("CC Capital"), of which the Reporting Person is the managing member of, as well as the controlling owner. The Reporting Person disclaims beneficial ownership of the reported securities except to the extent of his pecuniary interest therein.
4. On December 1, 2017, CC Capital purchased 2,750,000 Ordinary Shares at a purchase price of $10.00 per share from the Issuer. Additionally, CC Capital received 916,667 PPWs from the Issuer in connection with this transaction.
5. On November 29, 2017, CF Capital Growth, LLC ("CF Capital") distributed all of its Class B Ordinary Shares and PPWs to its members, except for 30,221 Class B Ordinary Shares, which were transferred to the Issuer's independent directors. The Reporting Person received 4,585,874 Class B Ordinary Shares and 8,650,000 PPWs pursuant to this distribution in the Reporting Person's capacity as a member of CF Capital. As a result, CF Capital no longer directly or indirectly owned any securities or derivative securities of the Issuer. Immediately prior to this distribution, CF Capital forfeited 2,048,030 Class B Ordinary Shares to CF Corporation. Prior to this distribution, the Reporting Person held 202,206 Class B Ordinary Shares through CC Capital.
6. Warrants acquired by CF Capital, pursuant to the conversion of a $1,500,000 loan made to CF Corporation pursuant to the convertible note, dated November 29, 2017, between CF Corporation and CF Capital.
/s/ Joel Rubinstein, Attorney-in-Fact 12/01/2017
** 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 4 (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).
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