SEC FORM 4 SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

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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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
VPC Impact Acquisition Holdings Sponsor III, LLC

(Last) (First) (Middle)
C/O VICTORY PARK CAPITAL ADVISORS, LLC
150 NORTH RIVERSIDE PLAZA, SUITE 5200

(Street)
CHICAGO IL 60606

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
VPC Impact Acquisition Holdings III, Inc. [ VPCC ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director X 10% Owner
Officer (give title below) X Other (specify below)
See Remarks
3. Date of Earliest Transaction (Month/Day/Year)
03/12/2021
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
Form filed by One Reporting Person
X Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction 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
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction 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 (Month/Day/Year) 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: 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
Class B Common Stock (1) 03/12/2021 J(1) 124,600 (2) (2) Class B Common Stock 124,600 $0.00 6,344,150 D(3)
1. Name and Address of Reporting Person*
VPC Impact Acquisition Holdings Sponsor III, LLC

(Last) (First) (Middle)
C/O VICTORY PARK CAPITAL ADVISORS, LLC
150 NORTH RIVERSIDE PLAZA, SUITE 5200

(Street)
CHICAGO IL 60606

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Levy Richard N

(Last) (First) (Middle)
C/O VICTORY PARK CAPITAL ADVISORS, LLC
150 NORTH RIVERSIDE PLAZA, SUITE 5200

(Street)
CHICAGO IL 60606

(City) (State) (Zip)
Explanation of Responses:
1. On March 12, 2021, VPC Impact Acquisition Holdings Sponsor III, LLC forfeited at no cost 124,600 shares of Class B common stock of the Issuer in connection with the election by the underwriters of the Issuer's initial public offering of units to exercise an option granted to them to cover over-allotments in part and not in full.
2. The shares of Class B common stock are convertible for shares of the Issuer's Class A common stock as described under the heading "Description of Securities" in the Issuer's Registration Statement on Form S-1 (File No. 333-252577) (the "Registration Statement") and have no expiration date.
3. VPC Impact Acquisition Holdings Sponsor III, LLC is the record holder of the securities reported herein. Richard N. Levy, as Chief Executive Officer and Founder of Victory Park Capital Advisors, LLC, has voting and investment discretion with respect to the securities held of record by VPC Impact Acquisition Holdings Sponsor III, LLC. Mr. Levy disclaims any beneficial ownership of the securities held by VPC Impact Acquisition Holdings Sponsor III, LLC other than to the extent of any pecuniary interest he may have therein, directly or indirectly.
Remarks:
Director by Deputization See Exhibit 99.1 - Joint Filer Information, which is incorporated herein by reference and describes in further detail the relationships of the Reporting Persons to the Issuer.
/s/ Eric Clamage, Attorney-in-Fact for VPC Acquisition Holdings Sponsor III, LLC 03/12/2021
/s/ Eric Clamage, Attorney-in-Fact for Richard N. Levy 03/12/2021
** 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 4 (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.
                                                                    Exhibit 99.1

                            Joint Filer Information

Name of Joint Filer:                  VPC Impact Acquisition Holdings Sponsor
                                      III,LLC
Address of Joint Filer:               c/o Victory Park Capital Advisors, LLC
                                      150 North Riverside Plaza, Suite 5200
                                      Chicago, IL 60606

Relationship of Joint
Filer to Issuer:                      10% Owner, Director

Issuer Name and Ticker
of Trading Symbol:                    VPC Impact Acquisition Holdings III Inc.
                                      [VPCC]

Date of Event Requiring Statement:    03/12/2021

(Month/Day/Year):


Name of Joint Filer:                  Richard M. Levy

Address of Joint Filer:               c/o VPC Park Capital Advisors, LLC
                                      150 North Riverside Plaza, Suite 5200
                                      Chicago, IL 60606

Relationship of Joint
Filer to Issuer:                      10% Owner

Issuer Name and Ticker
of Trading Symbol:                    VPC Impact Acquisition Holdings III, Inc.
                                      [VPCC]

Date of Event Requiring Statement:    03/12/2021

(Month/Day/Year):