0001104659-21-089347.txt : 20210706 0001104659-21-089347.hdr.sgml : 20210706 20210706145817 ACCESSION NUMBER: 0001104659-21-089347 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210629 FILED AS OF DATE: 20210706 DATE AS OF CHANGE: 20210706 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: UAW Retiree Medical Benefits Trust CENTRAL INDEX KEY: 0001480561 STATE OF INCORPORATION: XX FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 814-01407 FILM NUMBER: 211073713 BUSINESS ADDRESS: STREET 1: 200 WALKER STREET CITY: DETROIT STATE: MI ZIP: 48207 BUSINESS PHONE: 313-324-5928 MAIL ADDRESS: STREET 1: 200 WALKER STREET CITY: DETROIT STATE: MI ZIP: 48207 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: HARPER HERSHEL CENTRAL INDEX KEY: 0001794997 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 814-01407 FILM NUMBER: 211073714 MAIL ADDRESS: STREET 1: C/O UAW RETIREE MEDICAL BENEFITS TRUST STREET 2: 200 WALKER STREET CITY: DETROIT STATE: MI ZIP: 48207 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: UAW GM RETIREES MEDICAL BENEFITS PLAN CENTRAL INDEX KEY: 0001795050 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 814-01407 FILM NUMBER: 211073715 BUSINESS ADDRESS: STREET 1: 200 WALKER STREET CITY: DETROIT STATE: MI ZIP: 48207 BUSINESS PHONE: 313-324-5928 MAIL ADDRESS: STREET 1: 200 WALKER STREET CITY: DETROIT STATE: MI ZIP: 48207 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: UAW Ford Retireees Medical Benefits Plan CENTRAL INDEX KEY: 0001795052 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 814-01407 FILM NUMBER: 211073716 BUSINESS ADDRESS: STREET 1: 200 WALKER STREET CITY: DETROIT STATE: MI ZIP: 48207 BUSINESS PHONE: 313-324-5928 MAIL ADDRESS: STREET 1: 200 WALKER STREET CITY: DETROIT STATE: MI ZIP: 48207 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: UAW Chrysler Retireees Medical Benefits Plan CENTRAL INDEX KEY: 0001795057 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 814-01407 FILM NUMBER: 211073717 BUSINESS ADDRESS: STREET 1: 200 WALKER STREET CITY: DETROIT STATE: MI ZIP: 48207 BUSINESS PHONE: 313-324-5928 MAIL ADDRESS: STREET 1: 200 WALKER STREET CITY: DETROIT STATE: MI ZIP: 48207 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: NC SLF Inc. CENTRAL INDEX KEY: 0001844684 IRS NUMBER: 000000000 STATE OF INCORPORATION: MD FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 430 PARK AVENUE STREET 2: 14TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10022 BUSINESS PHONE: 2122072003 MAIL ADDRESS: STREET 1: 430 PARK AVENUE STREET 2: 14TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10022 3 1 tm2121529-1_3seq1.xml OWNERSHIP DOCUMENT X0206 3 2021-06-29 0 0001844684 NC SLF Inc. NONE 0001480561 UAW Retiree Medical Benefits Trust 1155 BREWERY PARK BLVD., SUITE 400 DETROIT MI 48207 0 0 1 0 0001795057 UAW Chrysler Retireees Medical Benefits Plan C/O UAW RETIREE MEDICAL BENEFITS TRUST 1155 BREWERY PARK BLVD., SUITE 400 DETROIT MI 48207 0 0 1 0 0001795052 UAW Ford Retireees Medical Benefits Plan C/O UAW RETIREE MEDICAL BENEFITS TRUST 1155 BREWERY PARK BLVD., SUITE 400 DETROIT MI 48207 0 0 1 0 0001795050 UAW GM RETIREES MEDICAL BENEFITS PLAN C/O UAW RETIREE MEDICAL BENEFITS TRUST 1155 BREWERY PARK BLVD., SUITE 400 DETROIT MI 48207 0 0 1 0 0001794997 HARPER HERSHEL C/O UAW RETIREE MEDICAL BENEFITS TRUST 1155 BREWERY PARK BLVD., SUITE 400 DETROIT MI 48207 0 0 1 0 Common Stock 1158435 D Common Stock 1805971 D Common Stock 2976287 D These Shares are owned directly by the UAW Chrysler Retirees Medical Benefits Plan. The UAW Chrysler Retirees Medical Benefits Plan is an employee welfare benefit plan established under the UAW RMBT. Hershel Harper is the Chief Investment Officer of the UAW RMBT. The UAW RMBT is deemed to be the indirect beneficial owner of these Shares by reason of its ability to direct the vote and/or disposition of such Shares. The UAW RMBT does not have a pecuniary interest in such Shares (within the meaning of Rule 16a-1(a)(2) under the Securities Exchange Act of 1934, as amended (the "Exchange Act")). Hershel Harper is deemed to be the indirect beneficial owner of these Shares by reason of his ability to direct the vote and/or disposition of such Shares. Hershel Harper does not have a pecuniary interest in such Shares (within the meaning of Rule 16a-1(a)(2) under the Exchange Act). These Shares are owned directly by the UAW Ford Retirees Medical Benefits Plan. The UAW Ford Retirees Medical Benefits Plan is an employee welfare benefit plan established under the UAW RMBT. Hershel Harper is the Chief Investment Officer of the UAW RMBT. The UAW RMBT is deemed to be the indirect beneficial owner of these Shares by reason of its ability to direct the vote and/or disposition of such Shares. The UAW RMBT does not have a pecuniary interest in such Shares (within the meaning of Rule 16a-1(a)(2) under the Exchange Act). Hershel Harper is deemed to be the indirect beneficial owner of these Shares by reason of his ability to direct the vote and/or disposition of such Shares. Hershel Harper does not have a pecuniary interest in such Shares (within the meaning of Rule 16a-1(a)(2) under the Exchange Act). These Shares are owned directly by the UAW GM Retirees Medical Benefits Plan. The UAW GM Retirees Medical Benefits Plan is an employee welfare benefit plan established under the UAW RMBT. Hershel Harper is the Chief Investment Officer of the UAW RMBT. The UAW RMBT is deemed to be the indirect beneficial owner of these Shares by reason of its ability to direct the vote and/or disposition of such Shares. The UAW RMBT does not have a pecuniary interest in such Shares (within the meaning of Rule 16a-1(a)(2) under the Exchange Act). Hershel Harper is deemed to be the indirect beneficial owner of these Shares by reason of his ability to direct the vote and/or disposition of such Shares. Hershel Harper does not have a pecuniary interest in such Shares (within the meaning of Rule 16a-1(a)(2) under the Exchange Act). This Form 3 is being filed by (i) UAW Retiree Medical Benefits Trust, organized as a 501(c)(9) Voluntary Employee Beneficiary Association (the "UAW RMBT"); (ii) UAW Chrysler Retirees Medical Benefits Plan, as established and maintained by the UAW Chrysler Retirees Employees' Beneficiary Association, an employee organization within the meaning of Section 3(4) of the Employee Retirement Income Security Act of 1974, as amended ("ERISA") under the UAW RMBT (the "UAW Chrysler Retirees Medical Benefits Plan"); (iii) UAW Ford Retirees Medical Benefits Plan, as established and maintained by the UAW Ford Retirees Employees' Beneficiary Association, an employee organization within the meaning of Section 3(4) of ERISA under the UAW RMBT (the "UAW Ford Retirees Medical Benefits Plan"); (iv) UAW GM Retirees Medical Benefits Plan, as established and maintained by the UAW GM Retirees Employees' Beneficiary Association, an employee organization within the meaning of Section 3(4) of ERISA under the UAW RMBT (the "UAW GM Retirees Medical Benefits Plan"); and (v) Hershel Harper, a United States citizen and the Chief Investment Officer of the Trust (collectively, the "Reporting Persons"). The Reporting Persons are members of a group that owns more than 10% of the common stock (the "Shares") of NC SLF Inc. (the "Issuer"). UAW RETIREE MEDICAL BENEFITS TRUST By: /s/ Garon Meikle Name: Garon Meikle Title: Controller 2021-07-02 UAW CHRYSLER RETIREES MEDICAL BENEFITS PLAN By: /s/ Garon Meikle Name: Garon Meikle Title: Controller 2021-07-02 UAW FORD RETIREES MEDICAL BENEFITS PLAN By: /s/ Garon Meikle Name: Garon Meikle Title: Controller 2021-07-02 UAW GM RETIREES MEDICAL BENEFITS PLAN By: /s/ Garon Meikle Name: Garon Meikle Title: Controller 2021-07-02 HERSHEL HARPER /s/ Hershel Harper 2021-07-02