SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

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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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
SEQUOIA CAPITAL ISRAEL IV HOLDINGS, L.P.

(Last) (First) (Middle)
C/O: SHIMONY HOUSE OF FINANCE, 26 BEN
GURION ST., P.O BOX 2058, BNEI BRAK

(Street)
RAMAT GAN L3 5112001

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
Innovid Corp. [ CTV ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director X 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
05/22/2024
4. 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 Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 05/22/2024 S 8,000,000 D $2.1 9,697,224 I See Footnote(1)(2)
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
1. Name and Address of Reporting Person*
SEQUOIA CAPITAL ISRAEL IV HOLDINGS, L.P.

(Last) (First) (Middle)
C/O: SHIMONY HOUSE OF FINANCE, 26 BEN
GURION ST., P.O BOX 2058, BNEI BRAK

(Street)
RAMAT GAN L3 5112001

(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*
SC ISRAEL IV GENPAR, LTD.

(Last) (First) (Middle)
C/O: SHIMONY HOUSE OF FINANCE, 26 BEN
GURION ST., P.O BOX 2058, BNEI BRAK

(Street)
RAMAT GAN L3 5112001

(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*
SC ISRAEL IV MANAGEMENT, L.P.

(Last) (First) (Middle)
C/O: SHIMONY HOUSE OF FINANCE, 26 BEN
GURION ST., P.O BOX 2058, BNEI BRAK

(Street)
RAMAT GAN L3 5112001

(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*
SEQUOIA CAPITAL ISRAEL IV, L.P.

(Last) (First) (Middle)
C/O: SHIMONY HOUSE OF FINANCE, 26 BEN
GURION ST., P.O BOX 2058, BNEI BRAK

(Street)
RAMAT GAN L3 5112001

(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*
Levy Shmuel

(Last) (First) (Middle)
C/O: SHIMONY HOUSE OF FINANCE, 26 BEN
GURION ST., P.O BOX 2058, BNEI BRAK

(Street)
RAMAT GAN L3 5112001

(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*
SADGER HAIM

(Last) (First) (Middle)
C/O: SHIMONY HOUSE OF FINANCE, 26 BEN
GURION ST., P.O BOX 2058, BNEI BRAK

(Street)
RAMAT GAN L3 5112001

(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. SC ISRAEL IV GENPAR, LTD is the general partner of SC ISRAEL IV MANAGEMENT, L.P., which is the general partner of SEQUOIA CAPITAL ISRAEL IV L.P., which owns 100% of SEQUOIA CAPITAL ISRAEL IV HOLDINGS, L.P. As such, SC ISRAEL IV GENPAR, LTD shares voting and dispositive power with respect to the shares held by SEQUOIA CAPITAL ISRAEL IV HOLDINGS, L.P. The directors and stockholders of SC ISRAEL IV GENPAR, LTD. who exercise voting and investment discretion with respect to the shares held by SEQUOIA CAPITAL ISRAEL IV HOLDINGS, L.P. are Shmuel Levy and Haim Sadger. As a result, and by virtue of the relationship described in this footnote, each such person may be deemed to share voting and dispositive power with respect to the shares held by the Sequoia Capital Israel IV Holdings, L.P.
2. Each of SC ISRAEL IV GENPAR, LTD, SC ISRAEL IV MANAGEMENT, L.P., SEQUOIA CAPITAL ISRAEL IV L.P., Mr. Levy and Mr. Sadger disclaims beneficial ownership of the shares held by SEQUOIA CAPITAL ISRAEL IV HOLDINGS, L.P. except to the extent of its or his pecuniary interest therein, and the inclusion of these securities in this report shall not be deemed an admission of beneficial ownership of the reported securities for purposes of Section 16 or for any other purposes.
/s/ By Shmuel Levy, a Director of SC ISRAEL IV GENPAR, LTD 05/24/2024
/s/ By Shmuel Levy, a Director of SC ISRAEL IV GENPAR, LTD, the general partner of SC ISRAEL IV MANAGEMENT, L.P. 05/24/2024
/s/ By Shmuel Levy, a Director of SC ISRAEL IV GENPAR, LTD, the general partner of SC ISRAEL IV MANAGEMENT, L.P., the general partner of SEQUOIA CAPITAL ISRAEL IV L.P. 05/24/2024
/s/ By Shmuel Levy, a Director of SC ISRAEL IV GENPAR, LTD, the general partner of SC ISRAEL IV MANAGEMENT, L.P., the general partner of SEQUOIA CAPITAL ISRAEL IV L.P., which owns 100% of SEQUOIA CAPITAL ISRAEL IV HOLDINGS, L.P. 05/24/2024
/s/ Shmuel Levy 05/24/2024
/s/ Haim Sadger 05/24/2024
** 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 4 (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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