0000895345-23-000534.txt : 20230918 0000895345-23-000534.hdr.sgml : 20230918 20230918172036 ACCESSION NUMBER: 0000895345-23-000534 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230914 FILED AS OF DATE: 20230918 DATE AS OF CHANGE: 20230918 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Wai Conrad CENTRAL INDEX KEY: 0001971702 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39252 FILM NUMBER: 231261890 MAIL ADDRESS: STREET 1: 3401 MALLORY LANE STREET 2: SUITE 210 CITY: FRANKLIN STATE: TN 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 X0508 4 2023-09-14 0001801170 CLOVER HEALTH INVESTMENTS, CORP. /DE CLOV 0001971702 Wai Conrad C/O CLOVER HEALTH INVESTMENTS, CORP. 3401 MALLORY LANE, SUITE 210 FRANKLIN TN 37067 true Chief Technology Officer false Class A Common Stock 2023-09-14 4 F 0 96086 1.13 D 2653225 D Represents shares of Class A Common Stock that were automatically withheld to cover tax obligations upon the vesting, on September 14, 2023, of 6.25% of the original number of time-based restricted stock units ("RSUs") granted to the Reporting Person on March 14, 2022. The remaining RSUs will vest quarterly in equal installments of 6.25%, with the final vesting date occurring on March 14, 2026, subject to the continued service of the Reporting Person on each such vesting date. /s/Scott Leffler as attorney-in-fact for Conrad Wai 2023-09-18