0001801170-23-000070.txt : 20231027 0001801170-23-000070.hdr.sgml : 20231027 20231027162105 ACCESSION NUMBER: 0001801170-23-000070 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20231025 FILED AS OF DATE: 20231027 DATE AS OF CHANGE: 20231027 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Leffler Scott J. CENTRAL INDEX KEY: 0001832406 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39252 FILM NUMBER: 231355855 MAIL ADDRESS: STREET 1: C/O CLOVER HEALTH INVESTMENTS, CORP. STREET 2: 3401 MALLORY LANE, 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 wk-form4_1698438053.xml FORM 4 X0508 4 2023-10-25 0 0001801170 CLOVER HEALTH INVESTMENTS, CORP. /DE CLOV 0001832406 Leffler Scott J. C/O CLOVER HEALTH INVESTMENTS, CORP. 3401 MALLORY LANE, SUITE 210 FRANKLIN TN 37067 0 1 0 0 Chief Financial Officer 0 Class A Common Stock 2023-10-25 4 F 0 124002 0.91 D 4540841 D Represents shares of Class A Common Stock that were automatically withheld to cover tax obligations upon the vesting, on October 25, 2023, of 6.25% of the original number of time-based restricted stock units ("RSUs") granted to the Reporting Person on July 25, 2022, and timely reported on a Form 4 filed on July 26, 2022. The remaining RSUs vest quarterly in equal installments of 6.25%, with the final vesting date occurring on July 25, 2026, subject to the continued service of the Reporting Person on such vesting date. /s/ Scott J. Leffler 2023-10-27