Statement of Changes in Beneficial Ownership (4)
December 23 2020 - 05:55PM
Edgar (US Regulatory)
FORM 4
[ ]
Check this box if no longer subject to Section 16. Form 4 or Form 5
obligations may continue. See Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL
OWNERSHIP OF SECURITIES
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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 * Kazarinoff
Dimitri |
2. Issuer Name and Ticker or Trading
Symbol XL Fleet Corp. [ XL ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)__X__
Director _____
10% Owner
__X__ Officer (give title
below) _____ Other
(specify below)
Chief Executive Officer |
(Last)
(First)
(Middle)
C/O XL FLEET CORP., 145 NEWTON STREET |
3. Date of Earliest Transaction (MM/DD/YYYY)
12/21/2020
|
(Street)
BOSTON, MA 02135
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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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
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1.Title of Security
(Instr. 3) |
2. Trans. Date |
2A. Deemed Execution Date, if any |
3. Trans. 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 |
Common Stock |
12/21/2020 |
|
A |
|
15346 |
A |
(1) |
15346 |
D |
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Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible
securities)
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1. Title of Derivate Security
(Instr. 3) |
2. Conversion or Exercise Price of Derivative
Security |
3. Trans. Date |
3A. Deemed Execution Date, if any |
4. Trans. 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 |
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 of Derivative Security: 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 |
Stock Option (right to buy) |
$0.24 |
12/21/2020 |
|
A |
|
3808966 |
|
(2) |
12/5/2029 |
Common Stock |
3808966 |
(3) |
3808966 |
D |
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Explanation of
Responses: |
(1) |
Mr. Kazarinoff received
15,346 shares in exchange for his 20,267 shares of XL Hybrids,
Inc., a Delaware corporation ("Legacy XL"), in connection with the
Agreement and Plan of Reorganization, dated as of September 17,
2020, by and among Pivotal Investment Corporation II ("Pivotal"),
PIC II Merger Sub Corp., a Delaware corporation and wholly owned
subsidiary of Pivotal ("Merger Sub"), and Legacy XL, pursuant to
which Merger Sub merged with and into Legacy XL (the "Merger"),
with Legacy XL surviving as a wholly-owned subsidiary of Pivotal
(which subsequently changed its name to "XL Fleet Corp.", the
"Issuer"). |
(2) |
The shares underlying this
option vest in 48 equal monthly starting on October 7, 2019 subject
to Mr. Kazarinoff's continued service through the applicable
vesting dates. |
(3) |
Received in the Merger in
exchange for a stock option to acquire 5,030,400 shares of Legacy
XL common stock for $0.18 per share. |
Reporting
Owners
|
Reporting Owner Name / Address |
Relationships
|
Director |
10% Owner |
Officer |
Other |
Kazarinoff Dimitri
C/O XL FLEET CORP.
145 NEWTON STREET
BOSTON, MA 02135 |
X |
|
Chief Executive Officer |
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Signatures
|
/s/ Jenna Stewart,
Attorney-in-Fact |
|
12/23/2020 |
**Signature of Reporting
Person |
Date |