0001493152-24-000306.txt : 20240103 0001493152-24-000306.hdr.sgml : 20240103 20240103163051 ACCESSION NUMBER: 0001493152-24-000306 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20231229 FILED AS OF DATE: 20240103 DATE AS OF CHANGE: 20240103 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Bloom Retirement Holdings Inc. CENTRAL INDEX KEY: 0001466992 ORGANIZATION NAME: STATE OF INCORPORATION: CA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40308 FILM NUMBER: 24507051 BUSINESS ADDRESS: STREET 1: 3800 W. CHAPMAN AVENUE, THIRD FLOOR CITY: ORANGE STATE: CA ZIP: 92868 BUSINESS PHONE: 866-948-0003 MAIL ADDRESS: STREET 1: 3800 W. CHAPMAN AVENUE, THIRD FLOOR CITY: ORANGE STATE: CA ZIP: 92868 FORMER NAME: FORMER CONFORMED NAME: American Advisors Group DATE OF NAME CHANGE: 20090624 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Jahangiri Reza CENTRAL INDEX KEY: 0001971548 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40308 FILM NUMBER: 24507050 MAIL ADDRESS: STREET 1: C/O AMERICAN ADVISORS GROUP, INC. STREET 2: 18200 VON KARMAN AVENUE, SUITE 300 CITY: IRVINE STATE: CA ZIP: 92612 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Finance of America Companies Inc. CENTRAL INDEX KEY: 0001828937 STANDARD INDUSTRIAL CLASSIFICATION: MORTGAGE BANKERS & LOAN CORRESPONDENTS [6162] ORGANIZATION NAME: 02 Finance IRS NUMBER: 853474065 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 5830 GRANITE PARKWAY STREET 2: SUITE 400 CITY: PLANO STATE: TX ZIP: 75024 BUSINESS PHONE: 877-202-2666 MAIL ADDRESS: STREET 1: 5830 GRANITE PARKWAY STREET 2: SUITE 400 CITY: PLANO STATE: TX ZIP: 75024 4 1 ownership.xml X0508 4 2023-12-29 0 0001828937 Finance of America Companies Inc. FOA 0001466992 Bloom Retirement Holdings Inc. 895 DOVE STREET, SUITE 300 NEWPORT BEACH, CA 92660 0 0 1 0 0001971548 Jahangiri Reza 895 DOVE STREET, SUITE 300 NEWPORT BEACH, CA 92660 0 0 1 0 0 Class A Common Stock 2023-12-29 4 C 0 8000000 A 8000000 I See footnote FOAEC Units 2023-12-29 4 C 0 8000000 0 D Class A Common Stock 8000000 25893666 I See footnote Each limited liability company unit of Finance of America Equity Capital LLC (the "FOAEC Unit") is exchangeable for one share of Class A Common Stock of the Issuer at the option of the holder. The FOAEC Units do not expire. Bloom Retirement Holdings Inc. is the record holder of the securities reported herein. Reza Jahangiri is the majority shareholder of Bloom Retirement Holdings Inc. As such, Mr. Jahangiri may be deemed to share voting and dispositive power over the securities held by Bloom Retirement Holdings Inc. Bloom Retirement Holdings Inc., By: /s/ Reza Jahangiri, its majority shareholder 2024-01-03 /s/ Reza Jahangiri 2024-01-03