0000899243-21-033797.txt : 20210820
0000899243-21-033797.hdr.sgml : 20210820
20210820144835
ACCESSION NUMBER: 0000899243-21-033797
CONFORMED SUBMISSION TYPE: 4/A
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210804
FILED AS OF DATE: 20210820
DATE AS OF CHANGE: 20210820
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Pinkovezky Aviad
CENTRAL INDEX KEY: 0001875305
FILING VALUES:
FORM TYPE: 4/A
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39711
FILM NUMBER: 211193427
MAIL ADDRESS:
STREET 1: C/O HIPPO HOLDINGS INC.
STREET 2: 150 FOREST AVENUE
CITY: PALO ALTO
STATE: CA
ZIP: 94301
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Hippo Holdings Inc.
CENTRAL INDEX KEY: 0001828105
STANDARD INDUSTRIAL CLASSIFICATION: FIRE, MARINE & CASUALTY INSURANCE [6331]
IRS NUMBER: 981562010
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 150 FOREST AVENUE
CITY: PALO ALTO
STATE: CA
ZIP: 94301
BUSINESS PHONE: (650) 294-8463
MAIL ADDRESS:
STREET 1: 150 FOREST AVENUE
CITY: PALO ALTO
STATE: CA
ZIP: 94301
FORMER COMPANY:
FORMER CONFORMED NAME: Reinvent Technology Partners Z
DATE OF NAME CHANGE: 20201029
FORMER COMPANY:
FORMER CONFORMED NAME: Reinvent Technology Partners B
DATE OF NAME CHANGE: 20201013
4/A
1
doc4a.xml
FORM 4/A SUBMISSION
X0306
4/A
2021-08-04
2021-08-04
0
0001828105
Hippo Holdings Inc.
HIPO
0001875305
Pinkovezky Aviad
C/O HIPPO HOLDINGS INC.
150 FOREST AVENUE
PALO ALTO
CA
94301
0
1
0
0
Chief Product Officer
Common Stock
2021-08-04
4
A
0
1970920
A
1970920
I
See footnote
Common Stock
2021-08-04
4
D
0
300000
D
1670920
I
See footnote
Common Stock
2021-08-04
4
A
0
139081
A
139081
I
See footnote
Stock Option (Right to Buy)
0.16
2021-08-04
4
A
0
86929
A
2028-01-23
Common Stock
86929
86929
D
Stock Option (Right to Buy)
0.34
2021-08-04
4
A
0
260787
A
2029-01-22
Common Stock
260787
260787
D
Stock Option (Right to Buy)
0.34
2021-08-04
4
A
0
405674
A
2029-05-14
Common Stock
405674
405674
D
Stock Option (Right to Buy)
1.06
2021-08-04
4
A
0
347716
A
2030-12-03
Common Stock
347716
347716
D
Pursuant to the business combination of Hippo Holdings Inc. (the "Issuer") and Hippo Enterprises Inc. ("Old Hippo"), each share of Old Hippo outstanding common stock was automatically converted into the right to shares of the Issuer's Common Stock based on a 1 to 6.95433 conversion ratio ("Conversion Ratio"). In addition, each outstanding Old Hippo equity award was automatically converted into a corresponding equity award of the Issuer based on the Conversion Ratio and with the same terms and vesting conditions as the Old Hippo equity awards.
The original Form 4 filed by the Reporting Person on 8/4/2021 contained administrative errors. This Form 4/A corrects the aforementioned errors and accurately reflects the Reporting Person's ownership.
Shares held by Pinkovezky 2019 Living Trust.
Shares redeemed by the Issuer at a price per share of $10 in a transaction exempt pursuant to Rule 16b-3(e).
Shares held by NORTH POINT TRUST COMPANY, LLC, as Trustee of the EDP FAMILY IRREVOCABLE TRUST dated April 3, 2021.
1/48th of the shares underlying the option vest on each monthly anniversary measured from January 23, 2018, subject to the Reporting Person continuing to provide services to the Issuer through the applicable vesting date.
1/48th of the shares underlying the option vest on each monthly anniversary measured from January 23, 2019, subject to the Reporting Person continuing to provide services to the Issuer through the applicable vesting date.
1/48th of the shares underlying the option vest on each monthly anniversary measured from May 13, 2019, subject to the Reporting Person continuing to provide services to the Issuer through the applicable vesting date.
1/48th of the shares underlying the option vest on each monthly anniversary measured from December 1, 2020, subject to the Reporting Person continuing to provide services to the Issuer through the applicable vesting date.
/s/ Stewart Ellis, as Attorney-in-Fact for Aviad Pinkovezky
2021-08-19