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*
(Street)
| 2. Date of Event Requiring Statement (Month/Day/Year) 05/09/2019 | 3. Issuer Name and Ticker or Trading Symbol Uber Technologies, Inc [ UBER ] | |||||||||||||
4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
| 5. If Amendment, Date of Original Filed (Month/Day/Year) | ||||||||||||||
6. Individual or Joint/Group Filing (Check Applicable Line)
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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) |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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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 | ||||
Series G Redeemable Convertible Preferred Stock | (1) | (1) | Common Stock | 72,840,541 | (1) | D(2) |
Explanation of Responses: |
1. The shares of Series G Redeemable Convertible Preferred Stock ("Series G Preferred Stock") of Uber Technologies, Inc. (the "Issuer") are presently convertible, at the option of the holder, into shares of the Issuer's common stock on a one-for-one basis. Shares of Series G Preferred Stock will automatically convert into shares of the Issuer's common stock on a one-for-one basis, without payment or further consideration, immediately prior to the consummation of the Issuer's initial public offering. The shares of Series G Preferred Stock do not expire. |
2. The Public Investment Fund is the sovereign wealth fund of the Kingdom of Saudi Arabia. |
Remarks: |
His Excellency Yasir Al-Rumayyan, the managing director of The Public Investment Fund ("PIF"), serves on the Board of Directors (the "Board") of Uber Technologies, Inc. (the "Issuer") as a representative of PIF. PIF is filing this Form 3 as a director by deputization by virtue of its representation on the Board of the Issuer. |
THE PUBLIC INVESTMENT FUND, Name: /s/ H.E. Yasir Al-Rumayyan, Title: Managing Director | 05/09/2019 | |
** 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. | ||
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 Number. |