0001801170-23-000119.txt : 20231218 0001801170-23-000119.hdr.sgml : 20231218 20231218165240 ACCESSION NUMBER: 0001801170-23-000119 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20231214 FILED AS OF DATE: 20231218 DATE AS OF CHANGE: 20231218 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Wai Conrad CENTRAL INDEX KEY: 0001971702 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39252 FILM NUMBER: 231494467 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] ORGANIZATION NAME: 02 Finance 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_1702936350.xml FORM 4 X0508 4 2023-12-14 0 0001801170 CLOVER HEALTH INVESTMENTS, CORP. /DE CLOV 0001971702 Wai Conrad C/O CLOVER HEALTH INVESTMENTS, CORP. 3401 MALLORY LANE, SUITE 210 FRANKLIN TN 37067 0 1 0 0 Chief Technology Officer 0 Class A Common Stock 2023-12-14 4 F 0 96086 1 D 2997139 D Represents shares of Class A Common Stock that were automatically withheld to cover tax obligations upon the vesting, on December 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 2023-12-18