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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN 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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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
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 control number. | SEC 1474 (9-02) |
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 Underlying Securities (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 of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
GROSS WILLIAM C/O HELIOGEN, INC. 130 WEST UNION ST PASADENA, CA 91103 |
X | CHIEF EXECUTIVE OFFICER |
/s/ William Gross | 09/06/2022 | |
**Signature of Reporting Person | Date |
* | 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). |
(1) | The securities are held directly by Idealab Studio, LLC ("Idealab Studio"). Mr. Gross is the Chairman and Chief Executive Officer of Idealab Studio. In addition, Mr. Gross is co-Trustee of The Gross Goodstein Living Trust dated April 18, 2006 (the "Trust"), which owns a majority of the class of securities entitled to elect two directors to Idealab Studio's board of managers. As a result of the foregoing, Mr. Gross may be deemed to beneficially own the securities held by Idealab Studio. Mr. Gross disclaims beneficial ownership of such securities except to the extent of his pecuniary interest therein. |
(2) | The securities are held directly by the Trust. Reflects the receipt of securities from a pro rata, in-kind distribution from Idealab Studio to its members, including the Trust, for no additional consideration, and the receipt of such shares was exempt from reporting pursuant to Rule 16a-9 of the Securities Exchange Act of 1934, as amended. Mr. Gross, together with his wife, is co-Trustee of the Trust and may be deemed to beneficially own the securities held by the Trust. Mr. Gross disclaims beneficial ownership of such securities except to the extent of his pecuniary interest therein. |