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