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*
Scavo Robert L.

(Last) (First) (Middle)
1100 W. TOWN & COUNTRY RD.
SUITE 1600

(Street)
ORANGE CA 92868

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
04/20/2023
3. Issuer Name and Ticker or Trading Symbol
Alignment Healthcare, Inc. [ ALHC ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Chief Information Officer
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)
Common Stock 366,573(1) D
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
Options (Right to Buy) (2) 03/25/2031 Common Stock 325,833 $18 D
Options (Right to Buy) (3) 03/08/2032 Common Stock 36,496 $9.06 D
Explanation of Responses:
1. Includes (i) 81,504 shares of Common Stock of Alignment Healthcare, Inc. (the "Company"); (ii) 81,503 shares of unvested restricted stock, 50% of which vest on each of September 14, 2023 and September 14, 2024; (iii) 25,875 restricted stock units, each restricted stock unit representing the right to receive one share of Common Stock of the Company ("RSUs"), granted on March 25, 2021, 25% of which vested or will vest on the first four anniversaries of the grant date; (iv) 49,669 RSUs granted on March 8, 2022, 25% of which vested or will vest on the first four anniversaries of the grant date; and (v) 136,353 RSUs granted on September 12, 2022, 50% of which will vest on or about each of the third and fourth anniversaries of the grant date. An aggregate of 8,331 shares have been sold upon vesting of RSUs in non-discretionary sale-to-cover transactions. In each case, vesting is subject to the reporting person's continued service to the Company as of the applicable vesting date.
2. Options vested or will vest 25% on each of the first four anniversaries of the March 25, 2021 grant date, subject to the reporting person's continued service to the Company as of the applicable vesting date.
3. Options vested or will vest 25% on each of the first four anniversaries of the March 8, 2022 grant date, subject to the reporting person's continued service to the Company as of the applicable vesting date.
Remarks:
/s/ Richard A. Cross, as Attorney-in-Fact, for Robert L. Scavo 05/01/2023
** 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.
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