0001801170-24-000038.txt : 20240109 0001801170-24-000038.hdr.sgml : 20240109 20240109160333 ACCESSION NUMBER: 0001801170-24-000038 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20240107 FILED AS OF DATE: 20240109 DATE AS OF CHANGE: 20240109 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Soares Karen CENTRAL INDEX KEY: 0001999086 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39252 FILM NUMBER: 24523250 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_1704834204.xml FORM 4 X0508 4 2024-01-07 0 0001801170 CLOVER HEALTH INVESTMENTS, CORP. /DE CLOV 0001999086 Soares Karen C/O CLOVER HEALTH INVESTMENTS, CORP. 3401 MALLORY LANE, SUITE 210 FRANKLIN TN 37067 0 1 0 0 General Counsel & Secretary 0 Class A Common Stock 2024-01-07 4 F 0 3862 0.95 D 996189 D Represents shares of Class A Common Stock that were automatically withheld to cover tax obligations on January 7, 2024, due to the vesting of 25% of the original number of restricted stock units ("RSUs") granted to the Reporting Person on June 15, 2021. The remaining RSUs will vest on January 7, 2025, subject to the continued service of the Reporting Person on such date. /s/Peter J. Rivas as attorney-in-fact for Karen M. Soares 2024-01-09