SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person*
Fifth Wall Ventures Management GP, LLC

(Last) (First) (Middle)
6060 CENTER DRIVE, 10TH FLOOR

(Street)
LOS ANGELES CA 90045

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
08/02/2021
3. Issuer Name and Ticker or Trading Symbol
Hippo Holdings Inc. [ HIPO ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director X 10% Owner
Officer (give title below) Other (specify below)
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
Form filed by One Reporting Person
X Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock 22,262,672 I By Affiliate(1)(2)
Common Stock 51,447,246 I By Affiliate(2)(3)
Common Stock 458,603 I By Affiliate(2)(4)
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
1. Name and Address of Reporting Person*
Fifth Wall Ventures Management GP, LLC

(Last) (First) (Middle)
6060 CENTER DRIVE, 10TH FLOOR

(Street)
LOS ANGELES CA 90045

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
Fifth Wall Ventures Management, L.P.

(Last) (First) (Middle)
6060 CENTER DRIVE, 10TH FLOOR

(Street)
LOS ANGELES CA 90045

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
Fifth Wall Ventures GP, LLC

(Last) (First) (Middle)
6060 CENTER DRIVE, 10TH FLOOR

(Street)
LOS ANGELES CA 90045

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
Fifth Wall Ventures, L.P.

(Last) (First) (Middle)
6060 CENTER DRIVE, 10TH FLOOR

(Street)
LOS ANGELES CA 90045

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
Fifth Wall Ventures SPV IV, L.P.

(Last) (First) (Middle)
6060 CENTER DRIVE, 10TH FLOOR

(Street)
LOS ANGELES CA 90045

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
Fifth Wall Ventures SPV XVII, L.P.

(Last) (First) (Middle)
6060 CENTER DRIVE, 10TH FLOOR

(Street)
LOS ANGELES CA 90045

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
Explanation of Responses:
1. Represents securities held by Fifth Wall Ventures, L.P.
2. Fifth Wall Ventures GP, LLC is the general partner of Fifth Wall Ventures SPV XVII, L.P., Fifth Wall Ventures SPV IV, L.P. and Fifth Wall Ventures, L.P., each a Delaware limited partnership (the "Subsidiary Funds"). Fifth Wall Ventures Management, L.P. serves as the sole manager of Fifth Wall Ventures GP, LLC. Fifth Wall Ventures Management GP, LLC is the general partner of Fifth Wall Ventures Management, L.P. Each of Fifth Wall Ventures GP, LLC, Fifth Wall Ventures Management, L.P. and Fifth Wall Ventures Management GP, LLC expressly disclaims beneficial ownership of the shares held by each Subsidiary Fund. Each Subsidiary Fund expressly disclaims ownership of any shares held by any other Subsidiary Fund.
3. Represents securities held by Fifth Wall Ventures SPV IV, L.P. Effective as of October 23, 2018, Fifth Wall Ventures SPV IV, L.P. granted LEN FW Investor, LLC an irrevocable voting proxy (the "Proxy") in respect of all shares held by Fifth Wall Ventures SPV IV, L.P. The 51,447,246 shares held directly by Fifth Wall Ventures SPV IV L.P. are subject to the Proxy.
4. Represents securities held by Fifth Wall Ventures SPV XVII, L.P.
Remarks:
FIFTH WALL VENTURES MANAGEMENT GP, LLC; By: /s/ Andriy Mykhaylovskyy, Vice President 08/12/2021
FIFTH WALL VENTURES MANAGEMENT, L.P.; By: Fifth Wall Ventures Management GP, LLC, its general partner; By: /s/ Andriy Mykhaylovskyy, Vice President 08/12/2021
FIFTH WALL VENTURES GP, LLC; By: /s/ Andriy Mykhaylovskyy, Vice President 08/12/2021
FIFTH WALL VENTURES, L.P.; By: Fifth Wall Ventures GP, LLC, its general partner; By: /s/ Andriy Mykhaylovskyy, Vice President 08/12/2021
FIFTH WALL VENTURES SPV IV, L.P.; By: Fifth Wall Ventures GP, LLC, its general partner; By: /s/ Andriy Mykhaylovskyy, Vice President 08/12/2021
FIFTH WALL VENTURES SPV XVII, L.P.; By: Fifth Wall Ventures GP, LLC, its general partner; By: /s/ Andriy Mykhaylovskyy, Vice President 08/12/2021
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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