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*
Lauber Martin

(Last) (First) (Middle)
C/O VOLTA INC.
155 DE HARO STREET

(Street)
SAN FRANCISCO CA 94103

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
Volta Inc. [ VLTA ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
12/28/2022
4. 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 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
Class A Common Stock 12/28/2022 J(1) 83,013 A (1) 436,787 D
Class A Common Stock 12/28/2022 J(2) 510,535 D (2) 0 I By 19Y Ventures VI, LLC(3)
Class A Common Stock 12/28/2022 J(4) 822,054 D (4) 0 I By 19Y Ventures VI-2, LLC(3)
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
Explanation of Responses:
1. Represents shares of the Issuer's Class A Common Stock, par value $0.0001 per share (the "Class A Common Stock") acquired pursuant to a pro rata distribution in-kind from 19Y Ventures VI, LLC, made in accordance with the exemption afforded by Rule 16a-13 of the Securities Exchange Act of 1934, as amended (the "Exchange Act").
2. Represents shares of Class A Common Stock distributed in-kind from 19Y Ventures VI, LLC to the Reporting Person and to each of its other members, made in accordance with the exemption afforded by Rule 16a-13 of the Exchange Act.
3. The Reporting Person is the Managing Member of 19Y Ventures VI, LLC and 19Y Ventures VI-2, LLC. As Managing Member of these entities, the Reporting Person has voting and dispositive power with respect to the shares held by these entities and may be deemed to beneficially own the shares of common stock held by these entities.
4. Represents shares of Class A Common Stock distributed in-kind from 19Y Ventures VI-2, LLC to each of its members, made in accordance with the exemption afforded by Rule 16a-13 of the Exchange Act.
Remarks:
/s/ Michelle Kley, as Attorney-in-Fact 12/30/2022
** 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).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
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