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