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