CUSIP NO. 39957D102
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Page 2 of 5 Pages
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1
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NAMES OF REPORTING PERSONS
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Delida Costin
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2
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CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP
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(a)
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(b)
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3
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SEC USE ONLY
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4
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SOURCE OF FUNDS (SEE INSTRUCTIONS)
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PF
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5
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CHECK BOX IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT TO ITEM 2(D) OR 2(E)
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6
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CITIZENSHIP OR PLACE OF ORGANIZATION
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United States of America
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NUMBER OF SHARES BENEFICIALLY OWNED BY EACH REPORTING PERSON WITH
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7
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SOLE VOTING POWER
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1,550,359 (1),(2)
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8
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SHARED VOTING POWER
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17,615 (2)
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9
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SOLE DISPOSITIVE POWER
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1,550,359 (1),(2)
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10
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SHARED DISPOSITIVE POWER
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17,615 (2)
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11
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AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
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1,567,974 (1),(2)
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12
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CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN SHARES (SEE INSTRUCTIONS)
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13
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PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11)
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5.0% (3)
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14
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TYPE OF REPORTING PERSON (SEE INSTRUCTIONS)
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IN
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(1) |
This amount includes (i) 127,351 shares of Class B Common Stock (as defined herein), (ii) 1,128,998 shares of Class B Common Stock obtainable upon exercise of options, and (iii) 294,010 shares of Class B
Common Stock obtainable upon vesting and settlement of RSUs (as defined herein).
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(2) |
This amount includes 17,515 shares of Class B Common Stock.
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(3) |
Calculation is based on the sum of (i) 29,412,877 shares of Class A Common Stock (as defined herein) outstanding upon closing of the Business Combination (as defined herein), as provided by the Issuer, plus
(ii) 144,866 shares of Class A Common Stock issuable upon conversion of Class B Common Stock, (iii) 1,128,998 shares of Class A Common Stock issuable upon exercise service-based options, and (iv) 294,010 shares of Class A Common Stock
issuable upon vesting and settlement of RSUs, each of (ii) through (iv) which have been added to the total shares of Class A Common Stock outstanding in accordance with Rule 13d-3(d)(3) under the Act.
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CUSIP NO. 39957D102
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Page 3 of 5 Pages
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Item 1. |
Security and Issuer
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Item 2. |
Identity and Background
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Item 3. |
Source and Amount of Funds or Other Consideration
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CUSIP NO. 39957D102
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Page 4 of 5 Pages
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Item 4. |
Purpose of Transaction
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Item 5. |
Interest in Securities of the Issuer
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Item 6. |
Contracts, Arrangements, Understandings or Relationships with Respect to Securities of the Issuer.
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Item 7. |
Material to be Filed as Exhibits.
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Exhibit A: |
Form of Indemnity Agreement by and between the Issuer and its directors
and officers (incorporated by reference to Exhibit 10.8 to the Registration Statement on Form S-4/A (File No. 001-40263), filed by the Issuer with the SEC on May 13, 2022).
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CUSIP NO. 39957D102
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Page 5 of 5 Pages
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/s/ Delida Costin
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Delida Costin
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June 27, 2022
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