UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549INITIAL 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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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | SEC 1473 (7-02) | ||
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. |
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 of Derivative Security: Direct (D) or Indirect (I) (Instr. 5) |
6. Nature of Indirect Beneficial Ownership (Instr. 5) |
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Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
RJC GIS Holdings LLC C/O HIRERIGHT HOLDINGS CORPORATION 100 CENTERVIEW DRIVE, SUITE 300 NASHVILLE, TN 37214 |
X | |||
Conrad Jeanne S. C/O HIRERIGHT HOLDINGS CORPORATION 100 CENTERVIEW DRIVE, SUITE 300 NASHVILLE, TN 37214 |
X | |||
Conrad Raymond W. C/O HIRERIGHT HOLDINGS CORPORATION 100 CENTERVIEW DRIVE, SUITE 300 NASHVILLE, TN 37214 |
X |
/s/ Brian Copple, as Attorney-in-Fact, for RJC GIS Holdings, LLC | 10/28/2021 | |
**Signature of Reporting Person | Date | |
/s/ Brian Copple, as Attorney-in-Fact, for Jeanne S. Conrad | 10/28/2021 | |
**Signature of Reporting Person | Date | |
/s/ Brian Copple, as Attorney-in-Fact, for Raymond W. Conrad | 10/28/2021 | |
**Signature of Reporting Person | Date |
* | 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). |
(1) | All of the interests in RJC GIS Holdings, LLC are held by (a) The Raymond W. Conrad Revocable Trust dated April 17, 2009, of which Raymond Conrad is trustee; (b) The Jeanne S. Conrad Revocable Trust dated April 17, 2009, of which Jeanne Conrad is trustee; (c) The RWC Family Trust, of which Jeanne Conrad is trustee; and (d) the JSC Family Trust, of which Raymond Conrad is trustee. |
(2) | The reporting persons state that neither the filing of this statement nor anything herein shall be deemed an admission that such person is, for purposes of Section 16 of the Securities Exchange Act of 1934, as amended (the "Exchange Act"), or otherwise, the beneficial owner of any securities covered by this statement. The reporting persons disclaim beneficial ownership of the securities covered by this statement, except to the extent of the pecuniary interest of such person in such securities. |
Remarks: Exhibit List - Exhibit 24.1 - Power of Attorney |