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*
Saldarriaga Peter

(Last) (First) (Middle)
C/O BELONG ACQUISITION CORP.
TWO COMMERCE SQ 2001 MARKET ST, STE 3400

(Street)
PHILADELPHIA PA 19103

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
07/22/2021
3. Issuer Name and Ticker or Trading Symbol
Belong Acquisition Corp. [ BLNG ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director X 10% Owner
X Officer (give title below) Other (specify below)
President, CFO and Secretary
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
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)
Class A common shares 550,000(1)(2) I By Belong Acquisition Sponsor, LLC(3)
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
Class B common shares (4) (4) Class A common shares 4,450,000(2)(5) (4) I By Belong Acquisition Sponsor, LLC(3)
Warrants (6) (7) Class A common shares 275,000(2)(8) 11.5 I By Belong Acquisition Sponsor, LLC(3)
Explanation of Responses:
1. These shares underlie 550,000 units of the issuer that Belong Acquisition Sponsor, LLC has irrevocably committed to purchase.
2. The reporting person disclaims beneficial ownership of these securities, except to the extent of his pecuniary interest therein, and this report shall not be deemed an admission that the reporting person is the beneficial owner of such securities for any other purpose.
3. These shares are held directly by the issuer's sponsor, Belong Acquisition Sponsor, LLC, which is co-managed by the reporting person.
4. The Class B common shares will automatically convert into Class A common shares at the time of the issuer's initial business combination on a one-for-one basis, subject to certain adjustments described in the issuer's charter documents and have no expiration date.
5. Includes up to 562,500 shares that are subject to forfeiture in the event the underwriters of the issuer's initial public offering do not exercise in full their over-allotment option.
6. The warrants will become exercisable at the later of 30 days after the consummation of the issuer's initial business combination or 12 months from the completion of the issuer's initial public offering.
7. The warrants will expire five years after the consummation of the issuer's initial business combination or earlier upon redemption of all of the issuer's outstanding Class A common shares or the issuer's liquidation.
8. These warrants underlie 550,000 units of the issuer that Belong Acquisition Sponsor, LLC has irrevocably committed to purchase.
Remarks:
Exhibit 24 - Power of Attorney
/s/ Jennifer Deason, as attorney-in-fact 07/22/2021
** 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).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.