SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
Collier Creek Partners LLC

(Last) (First) (Middle)
C/O COLLIER CREEK HOLDINGS
200 PARK AVENUE, 58TH FLOOR

(Street)
NEW YORK NY 10166

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
Collier Creek Holdings [ CCH ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director X 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
10/19/2018
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
Form filed by One Reporting Person
X Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Class B Ordinary Shares (1) 10/19/2018 J(1) 500,000 (2) (2) Class A Ordinary Shares 500,000 $0 11,680,000 D(3)
1. Name and Address of Reporting Person*
Collier Creek Partners LLC

(Last) (First) (Middle)
C/O COLLIER CREEK HOLDINGS
200 PARK AVENUE, 58TH FLOOR

(Street)
NEW YORK NY 10166

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
Chu Chinh

(Last) (First) (Middle)
C/O COLLIER CREEK HOLDINGS
200 PARK AVENUE, 58TH FLOOR

(Street)
NEW YORK NY 10166

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
DEROMEDI ROGER K

(Last) (First) (Middle)
C/O COLLIER CREEK HOLDINGS
200 PARK AVENUE, 58TH FLOOR

(Street)
NEW YORK NY 10166

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
Giordano Jason K

(Last) (First) (Middle)
C/O COLLIER CREEK HOLDINGS
200 PARK AVENUE, 58TH FLOOR

(Street)
NEW YORK NY 10166

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
Explanation of Responses:
1. On October 19, 2018, Collier Creek Partners LLC forfeited at no cost 500,000 Class B ordinary shares, par value $0.0001 per share ("Class B Ordinary Shares"), in connection with the election by the underwriters of the Issuer's initial public offering to decline in part to exercise an option granted to them to cover over-allotments.
2. The Class B Ordinary Shares are convertible for the Issuer's Class A ordinary shares, par value $0.0001 per share, as described under the heading "Description of Securities" in the Issuer's registration statement on Form S-1 (File No. 333-227295) and have no expiration date.
3. The securities are held directly by Collier Creek Partners LLC. Chinh Chu, Roger K. Deromedi and Jason K. Giordano share voting and dispositive power over the securities held by Collier Creek Partners LLC. Chinh Chu, Roger K. Deromedi and Jason K. Giordano each disclaim beneficial ownership over any securities owned by Collier Creek Partners LLC other than to the extent of any pecuniary interest he may have therein, directly or indirectly.
/s/ Joel L. Rubinstein, Attorney-in-Fact for Collier Creek Partners LLC 10/19/2018
/s/ Joel L. Rubinstein, Attorney-in-Fact for Chinh Chu 10/19/2018
/s/ Joel L. Rubinstein, Attorney-in-Fact for Roger K. Deromedi 10/19/2018
/s/ Joel L. Rubinstein, Attorney-in-Fact for Jason K. Giordano 10/19/2018
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v).
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