Initial Statement of Beneficial Ownership (3)
August 10 2021 - 4:02PM
Edgar (US Regulatory)
FORM 3
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0104
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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
*
Len FW Investor, LLC |
2. Date of Event Requiring Statement (MM/DD/YYYY)
8/4/2021
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3. Issuer Name and Ticker or Trading Symbol
Hippo Holdings Inc. [HIPO]
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(Last)
(First)
(Middle)
700 NW 107TH AVE SUITE 400 |
4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
_____ Director ___X___ 10% Owner
_____ Officer (give title below) _____ Other (specify below)
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(Street)
MIAMI, FL 33172
(City)
(State)
(Zip)
| 5. If Amendment, Date Original Filed(MM/DD/YYYY)
| 6. Individual or Joint/Group Filing(Check Applicable Line)
___ Form filed by One Reporting Person
_X_ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Beneficially Owned
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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 (1) | 29339123 (2) | D | |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security
(Instr. 4) | 2. Date Exercisable and Expiration Date
(MM/DD/YYYY) | 3. Title and Amount of Securities Underlying Derivative Security
(Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form of Derivative Security: 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 |
| Explanation of Responses: |
| (1) | Pursuant to the business combination of Hippo Holdings Inc. (the "Issuer") and Hippo Enterprises Inc. ("Old Hippo"), each share of Old Hippo outstanding common stock was automatically converted into the right to shares of the Issuer's Common Stock based on a 1 to 6.95433 conversion ratio. |
| (2) | The securities are directly owned by Len FW Investor, LLC ("LEN FW"), the sole member of which is LEN X, LLC ("LENX"), which is a wholly-owned subsidiary of Lennar Corporation ("Lennar"), a publicly traded company with its stock listed on the NYSE. LENX and Lennar are indirect beneficial owners and disclaim beneficial ownership except to the extent of their pecuniary interest therein. LEN FW holds a proxy to vote an additional 51,477,246 shares, but it has no pecuniary interest in those shares. |
Reporting Owners
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| Reporting Owner Name / Address | Relationships |
| Director | 10% Owner | Officer | Other |
Len FW Investor, LLC
700 NW 107TH AVE SUITE 400
MIAMI, FL 33172 |
| X |
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LENNAR CORP /NEW/
700 NW 107TH AVE SUITE 400
MIAMI, FL 33172 |
| X |
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Len X, LLC
700 NW 107TH AVE SUITE 400
MIAMI, FL 33172 |
| X |
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Signatures
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| /s/ Mark Sustana as VP, GC and Secretary of Lennar Corporation | | 8/10/2021 |
| **Signature of Reporting Person | Date |
| /s/ Mark Sustana as VP of LEN X, LLC | | 8/10/2021 |
| **Signature of Reporting Person | Date |
| /s/ Mark Sustana as VP of LEN FW Investor, LLC | | 8/10/2021 |
| **Signature of Reporting Person | Date |
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