UNITED STATES
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SECURITIES AND EXCHANGE COMMISSION
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Washington, D.C. 20549
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SCHEDULE 13D
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Under the Securities Exchange Act of 1934
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(Amendment No. 2)*
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CLOVER HEALTH INVESTMENTS, CORP.
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(Name of Issuer)
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Class A Common Stock
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(Title of Class of Securities)
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18914F111
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(CUSIP Number)
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Chamath Palihapitiya
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506 Santa Cruz Avenue, Suite 300
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Menlo Park, California 94025
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(650) 521-9007
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(Name, Address and Telephone Number of Person Authorized to Receive Notices and Communications)
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with copies to:
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Gregg A. Noel
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Skadden, Arps, Slate, Meagher & Flom LLP
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One Manhattan West
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New York, New York 10001-8602
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(212) 735-3000
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September 29, 2022
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(Date of Event Which Requires Filing of This Statement)
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If the filing person has previously filed a statement on Schedule 13G to report the acquisition that is the subject of this Schedule 13D, and is
filing this schedule because of §§ 240.13d-1(e), 240.13d-1(f) or 240.13d-1(g), check the following box. ☐
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Note: Schedules filed in paper format shall include a signed original and five copies of
the schedule, including all exhibits. See § 240.13d-7 for other parties to whom copies are to be sent.
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* |
The remainder of this cover page shall be filled out for a reporting person’s initial filing on this form with respect to the subject class of securities, and for any
subsequent amendment containing information which would alter disclosures provided in a prior cover page.
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CUSIP No. 18914F111
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Page 2 of 5 pages
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1
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Name of Reporting Person
ChaChaCha SPAC C LLC
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2.
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Check the Appropriate Box if a Member of a Group
(a)☐ (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
WC, BK
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5.
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Check if Disclosure of Legal Proceedings Is Required Pursuant to Items 2(d) or 2(e)
☐
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6.
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Citizenship or Place of Organization
Cayman Islands
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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
19,132,693
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||||
8.
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Shared Voting Power
0
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9.
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Sole Dispositive Power
19,132,693
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10.
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Shared Dispositive Power
0
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11.
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Aggregate Amount Beneficially Owned by Each Reporting Person
19,132,693
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|||||
12.
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Check if the Aggregate Amount in Row (11) Excludes Certain Shares
☐
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13.
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Percent of ClassRepresented by Amount in Row (11)
4.99%
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14.
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Type of Reporting Person
OO
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CUSIP No. 18914F111
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Page 3 of 5 pages
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1
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Name of Reporting Person
Chamath Palihapitiya
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|||||
2.
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Check the Appropriate Box if a Member of a Group
(a)☐ (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
WC, BK
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|||||
5.
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Check if Disclosure of Legal Proceedings Is Required Pursuant to Items 2(d) or 2(e)
☐
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|||||
6.
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Citizenship or Place of Organization
United States
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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
19,132,693
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||||
8.
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Shared Voting Power
0
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|||||
9.
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Sole Dispositive Power
19,132,693
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|||||
10.
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Shared Dispositive Power
0
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|||||
11.
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Aggregate Amount Beneficially Owned by Each Reporting Person
19,132,693
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|||||
12.
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Check if the Aggregate Amount in Row (11) Excludes Certain Shares
☐
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|||||
13.
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Percent of ClassRepresented by Amount in Row (11)
4.99%
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|||||
14.
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Type of Reporting Person
IN
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Reporting Person(1)
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Amount beneficially owned
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Percent of class
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Sole power to vote or to direct the vote
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Shared power to vote or to direct the vote
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Sole power to dispose or to direct the disposition
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Shared power to dispose or to direct the disposition
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||||||
ChaChaCha SPAC C LLC
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19,132,693
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4.99%
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19,132,693
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0
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19,132,693
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0
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||||||
Chamath Palihapitiya(1)
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19,132,693
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4.99%
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19,132,693
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0
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19,132,693
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0
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ChaChaCha SPAC C LLC
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By:
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/s/ Chamath Palihapitiya
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Name:
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Chamath Palihapitiya
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Title:
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Manager
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Chamath Palihapitiya
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/s/ Chamath Palihapitiya
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