0000899243-21-041770.txt : 20211027
0000899243-21-041770.hdr.sgml : 20211027
20211027195013
ACCESSION NUMBER: 0000899243-21-041770
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20211025
FILED AS OF DATE: 20211027
DATE AS OF CHANGE: 20211027
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Tepper Jeffrey
CENTRAL INDEX KEY: 0001665610
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-40284
FILM NUMBER: 211354599
MAIL ADDRESS:
STREET 1: 1001 SEVENTEENTH STREET, SUITE 1800
STREET 2: C/O RIVERSTONE EQUITY
CITY: DENVER
STATE: CO
ZIP: 80202
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Decarbonization Plus Acquisition Corp III
CENTRAL INDEX KEY: 0001844862
STANDARD INDUSTRIAL CLASSIFICATION: MISCELLANEOUS ELECTRICAL MACHINERY, EQUIPMENT & SUPPLIES [3690]
IRS NUMBER: 861888095
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 2744 SAND HILL ROAD
CITY: MENLO PARK
STATE: CA
ZIP: 94025
BUSINESS PHONE: (212) 993-0076
MAIL ADDRESS:
STREET 1: 2744 SAND HILL ROAD
CITY: MENLO PARK
STATE: CA
ZIP: 94025
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2021-10-25
0
0001844862
Decarbonization Plus Acquisition Corp III
DCRC
0001665610
Tepper Jeffrey
C/O DECARBONIZATION PLUS ACQ CORP III
2744 SAND HILL ROAD, SUITE 100
MENLO PARK
CA
94025
1
0
0
0
Class A Common Stock
2021-10-25
4
C
0
40000
A
40000
D
Class B Common Stock
2021-10-25
4
C
0
40000
D
Class A Common Stock
40000
0
D
In accordance with the amended and restated certificate of incorporation of Decarbonization Plus Acquisition Corporation III ("DCRC"), the Reporting Person elected to convert his shares of Class B Common Stock into shares of Class A Common Stock on a one-for-one basis.
The shares of Class B Common Stock were (i) convertible into shares of Class A Common Stock at the Reporting Person's election on a one-for-one basis and (ii) automatically convertible into shares of Class A Common Stock at the time of DCRC's initial business combination on a one-for-one basis, subject to adjustment pursuant to certain anti-dilution rights (which rights were waived by the Reporting Person in connection with DCRC's proposed business combination), and had no expiration date.
Jeffrey Tepper, /s/ Peter Haskopoulos, Attorney-in-fact
2021-10-27