Form Type: 4

SEC EDGAR Link
Accession Number:0001213900-21-032594
Date:2021-06-09
Issuer: KATAPULT HOLDINGS, INC. (KPLT)
Original Submission Date:

Reporting Person:

TARAGIN BRUCE
C/O KATAPULT HOLDINGS, INC.
5204 TENNYSON PARKWAY, SUITE 500 PLANO, TX 75024

Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
Title of SecurityTransaction Date2a. Deemed Execution Date Transaction CodeSharesAcquired or DisposedPrice per share 5. Amount of Securities Beneficially Owned Following Reported Transaction 6. Ownership Form Direct or IndirectNature of Indirect Ownership
COMMON STOCK 2021-06-09 J 6,465,834 a $0.00 6,465,834 indirect
Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, convertible securities
Title of Derivative Security Conversion or Exercise Price of Derivative Security Transaction Date Deemed Execution Date Transaction Code Number of Derivative Securities Acquired (A) or Disposed of (D) Date ExercisableExpiration Date Title and Amount of Securities Underlying Derivative Security Price of Derivative Security Number of derivative Securities Beneficially Owned Following Reported Transaction(s) Ownership Form: Direct (D) or Indirect (I) Nature of Indirect Beneficial Ownership
Footnotes
IDfootnote
f1 shares were acquired pursuant to katapult holdings, inc.'s (the "issuer") initial business combination in exchange for shares of the legacy katapult holdings, inc. entity that were owned by blumberg capital iii, l.p. prior to the closing.
f2 includes earn out shares granted in connection with the issuer's initial business combination, subject to certain vesting provisions.
f3 shares held by blumberg capital iii, l.p., of which mr. taragin is a managing director. mr. taragin disclaims any beneficial ownership of the reported shares other than to the extent of any pecuniary interest they may have therein, directly or indirectly.
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