0000899243-21-010551.txt : 20210308 0000899243-21-010551.hdr.sgml : 20210308 20210308214739 ACCESSION NUMBER: 0000899243-21-010551 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210308 FILED AS OF DATE: 20210308 DATE AS OF CHANGE: 20210308 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Corr Jonathan CENTRAL INDEX KEY: 0001513905 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40178 FILM NUMBER: 21723956 MAIL ADDRESS: STREET 1: ELLIE MAE, INC. STREET 2: 4420 ROSEWOOD DRIVE, SUITE 500 CITY: PLEASANTON STATE: CA ZIP: 94588 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Independence Holdings Corp. CENTRAL INDEX KEY: 0001837393 STANDARD INDUSTRIAL CLASSIFICATION: BLANK CHECKS [6770] IRS NUMBER: 000000000 STATE OF INCORPORATION: E9 FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 277 PARK AVENUE STREET 2: 29TH FLOOR, SUITE B CITY: NEW YORK STATE: NY ZIP: 10172 BUSINESS PHONE: 2127043050 MAIL ADDRESS: STREET 1: 277 PARK AVENUE STREET 2: 29TH FLOOR, SUITE B CITY: NEW YORK STATE: NY ZIP: 10172 3 1 doc3.xml FORM 3 SUBMISSION X0206 3 2021-03-08 0 0001837393 Independence Holdings Corp. ACQRU 0001513905 Corr Jonathan 277 PARK AVENUE, 29TH FLOOR SUITE B NEW YORK NY 10172 1 0 0 0 Class B Ordinary Shares Class A Ordinary Shares 25000 D The reporting person owns 25,000 Class B Ordinary Shares which will automatically convert into Class A ordinary shares at the time of the registrant's initial business combination on a one-for-one basis (unless otherwise provided in our initial business combination agreement), subject to adjustment for share subdivisions, share consolidations, share capitalizations, reorganizations, recapitalizations and the like, and certain anti-dilution rights as described under the heading "Description of Securities-Founder Shares" in the Issuer's registration statement on Form S-1 (File No. 333-253095) and have no expiration date. /s/ Jonathan Corr 2021-03-08