0000895345-23-000304.txt : 20230516
0000895345-23-000304.hdr.sgml : 20230516
20230516213911
ACCESSION NUMBER: 0000895345-23-000304
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20230515
FILED AS OF DATE: 20230516
DATE AS OF CHANGE: 20230516
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Kouzoukas Demetrios L.
CENTRAL INDEX KEY: 0001856511
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39252
FILM NUMBER: 23929510
MAIL ADDRESS:
STREET 1: C/O CLOVER HEALTH INVESTMENTS, CORP.
STREET 2: 725 COOL SPRINGS BLVD., SUITE 320
CITY: FRANKLIN
STATE: FL
ZIP: 37067
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: CLOVER HEALTH INVESTMENTS, CORP. /DE
CENTRAL INDEX KEY: 0001801170
STANDARD INDUSTRIAL CLASSIFICATION: HOSPITAL & MEDICAL SERVICE PLANS [6324]
IRS NUMBER: 981515192
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 3401 MALLORY LANE, SUITE 210
CITY: FRANKLIN
STATE: TN
ZIP: 37067
BUSINESS PHONE: (201) 432-2133
MAIL ADDRESS:
STREET 1: 3401 MALLORY LANE, SUITE 210
CITY: FRANKLIN
STATE: TN
ZIP: 37067
FORMER COMPANY:
FORMER CONFORMED NAME: CLOVER HEALTH INVESTMENTS, CORP.
DATE OF NAME CHANGE: 20210107
FORMER COMPANY:
FORMER CONFORMED NAME: Social Capital Hedosophia Holdings Corp. III
DATE OF NAME CHANGE: 20200124
4
1
form4.xml
X0407
4
2023-05-15
0001801170
CLOVER HEALTH INVESTMENTS, CORP. /DE
CLOV
0001856511
Kouzoukas Demetrios L.
C/O CLOVER HEALTH INVESTMENTS, CORP.
3401 MALLORY LANE, SUITE
FRANKLIN
FL
37067
true
false
Class A Common Stock
2023-05-15
4
A
0
36585
0
A
259455
D
Represents shares of Class A common stock of Clover Health Investments, Corp. (the "Company") underlying a time-based restricted stock unit award ("RSUs"). The RSUs will vest in full on the first anniversary of May 15, 2023, subject to the Reporting Person's continued service as a member of the Company's Board of Directors through such vesting date.
Josheph R. Martin, Attorney-in-Fact
2023-05-16