0000950142-20-002862.txt : 20201222 0000950142-20-002862.hdr.sgml : 20201222 20201222154543 ACCESSION NUMBER: 0000950142-20-002862 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20201218 FILED AS OF DATE: 20201222 DATE AS OF CHANGE: 20201222 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Klein Michael Stuart CENTRAL INDEX KEY: 0001327392 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39806 FILM NUMBER: 201407895 MAIL ADDRESS: STREET 1: C/O DAVIS POLK & WARDWELL STREET 2: 450 LEXINGTON AVENUE CITY: NEW YORK STATE: NY ZIP: 10017 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: M. Klein Associates, Inc. CENTRAL INDEX KEY: 0001751504 STATE OF INCORPORATION: NY FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39806 FILM NUMBER: 201407896 BUSINESS ADDRESS: STREET 1: 640 FIFTH AVENUE, 12TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10019 BUSINESS PHONE: 212-380-7500 MAIL ADDRESS: STREET 1: 640 FIFTH AVENUE, 12TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10019 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Churchill Sponsor V LLC CENTRAL INDEX KEY: 0001812232 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39806 FILM NUMBER: 201407897 BUSINESS ADDRESS: STREET 1: 640 FIFTH AVENUE, 12TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10019 BUSINESS PHONE: (212) 380-7500 MAIL ADDRESS: STREET 1: 640 FIFTH AVENUE, 12TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10019 FORMER NAME: FORMER CONFORMED NAME: One Judith Sponsor LLC DATE OF NAME CHANGE: 20200514 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Churchill Capital Corp V CENTRAL INDEX KEY: 0001812234 STANDARD INDUSTRIAL CLASSIFICATION: BLANK CHECKS [6770] IRS NUMBER: 851023777 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 640 FIFTH AVENUE, 12TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10019 BUSINESS PHONE: (212) 380-7500 MAIL ADDRESS: STREET 1: 640 FIFTH AVENUE, 12TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10019 FORMER COMPANY: FORMER CONFORMED NAME: One Judith Acquisition Corp DATE OF NAME CHANGE: 20200514 4 1 es2001211197_4-ccvmka.xml OWNERSHIP DOCUMENT X0306 4 2020-12-18 0 0001812234 Churchill Capital Corp V CCV 0001812232 Churchill Sponsor V LLC 640 FIFTH AVENUE, 12TH FLOOR NEW YORK NY 10019 0 0 1 0 0001751504 M. Klein Associates, Inc. 640 FIFTH AVENUE, 12TH FLOOR NEW YORK NY 10019 0 0 1 0 0001327392 Klein Michael Stuart 640 5TH AVENUE, 12TH FLOOR NEW YORK NY 10019 0 0 1 0 Class B common stock 2020-12-18 4 J 0 437500 0 D Class A Common Stock 437500 12500000 I See footnote As described in the Issuer's registration statement on Form S-1 (File No. 333-248972) under the heading "Description of Securities - Founder Shares," the shares of Class B common stock will automatically convert into shares of Class A common stock at the time of the Issuer's initial business combination, or at any time prior thereto at the option of the holder, on a one-for-one basis, subject to certain adjustments described therein and have no expiration date. On December 18, 2020, Churchill Sponsor V LLC forfeited at no cost 437,500 shares of common stock, par value $0.0001 per share, in connection with the determination by the underwriters of the Issuer's initial public offering not to exercise in full the over-allotment option granted to them. Churchill Sponsor V LLC is the sponsor entity of the Issuer (the "Sponsor"). Michael Klein is the controlling stockholder of M. Klein Associates, Inc., which is the managing member of Churchill Sponsor V LLC. See Signatures included in Exhibit 99.1 2020-12-22 EX-99.1 2 es2001211197_ex9901.htm EXHIBIT 99.1

EXHIBIT 99.1

This statement on Form 4 is filed jointly by each of the undersigned.
 
Name of Designated Filer: Churchill Sponsor V LLC
 
Date of Event Requiring Statement: December 18, 2020
 
Issuer Name: Churchill Capital Corp V [CCV]


 
CHURCHILL SPONSOR V LLC
  
       
 
By:
/s/ Jay Taragin
  
   
Name: Jay Taragin
  
   
Title: Authorized Signatory
  
       
 
M. KLEIN ASSOCIATES, INC.
  
       
 
By:
/s/ Jay Taragin
  
   
Name: Jay Taragin
  
   
Title: Authorized Signatory
  
       
       
 
MICHAEL KLEIN
  
       
 
/s/ Michael Klein 
  
 
Michael Klein