Statement of Changes in Beneficial Ownership (4)
11 Maio 2021 - 5:12PM
Edgar (US Regulatory)
FORM 4
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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).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0287
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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
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TJF, LLC |
2. Issuer Name and Ticker or Trading Symbol
Landcadia Holdings IV, Inc.
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LCA
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director __X__ 10% Owner
_____ Officer (give title below) _____ Other (specify below)
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(Last)
(First)
(Middle)
C/O LANDCADIA HOLDINGS IV, INC., 1510 WEST LOOP SOUTH |
3. Date of Earliest Transaction
(MM/DD/YYYY)
5/10/2021 |
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(Street)
HOUSTON, TX 77027
(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)
___ Form filed by One Reporting Person
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X
_ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security
(Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code
(Instr. 8)
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4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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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 |
| Class B Common Stock | (1) | 5/10/2021 | | D (1) | | | 937500 | (2) | (2) | Class A Common Stock | 937500 | $0 | 6250000 | D (3) | |
| Explanation of Responses: |
| (1) | On May 10, 2021, TJF, LLC forfeited at no cost 937,500 shares of Class B common stock of the Issuer, which was exempted pursuant to Rule 16b-3(e) under the Securities Exchange Act of 1934, as amended (the "Exchange Act"), in connection with the election by the underwriters of the Issuer's initial public offering of units to not exercise an option granted to them to cover over-allotments. |
| (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. 333-253100) (the "Registration Statement") and have no expiration date. |
| (3) | The securities are held directly by TJF, LLC. Tilman J. Fertitta owns and controls TJF, LLC and has voting and dispositive control over the securities held directly by TJF, LLC |
Reporting Owners
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| Reporting Owner Name / Address | Relationships |
| Director | 10% Owner | Officer | Other |
TJF, LLC
C/O LANDCADIA HOLDINGS IV, INC.
1510 WEST LOOP SOUTH
HOUSTON, TX 77027 | X | X |
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FERTITTA TILMAN J
C/O LANDCADIA HOLDINGS IV, INC.
1510 WEST LOOP SOUTH
HOUSTON, TX 77027 | X | X |
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Signatures
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| /s/ Steven L. Scheinthal, Attorney-in-Fact for TJF, LLC | | 5/11/2021 |
| **Signature of Reporting Person | Date |
| /s/ Steven L. Scheinthal, Attorney-in-Fact for Tilman J. Fertitta | | 5/11/2021 |
| **Signature of Reporting Person | Date |
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