FORM 3 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
|
1. Name and Address of Reporting Person*
(Street)
|
2. Date of Event Requiring Statement
(Month/Day/Year) 06/17/2025 |
3. Issuer Name and Ticker or Trading Symbol
Slide Insurance Holdings, Inc. [ SLDE ] |
|||||||||||||
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
|
5. If Amendment, Date of Original Filed
(Month/Day/Year) |
||||||||||||||
6. Individual or Joint/Group Filing (Check Applicable Line)
|
Table I - Non-Derivative Securities Beneficially Owned | |||
---|---|---|---|
1. Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
Common Stock | 114,592(1) | D | |
Common Stock | 1,650,000(1) | I | By Securus Risk Management, LLC(2) |
Common Stock | 1,925,000(1) | I | By Emma Cloonen Irrevocable Trust |
Common Stock | 1,925,000(1) | I | By Ava Cloonen Irrevocable Trust |
Common Stock | 114,592(1) | I | By spouse(3) |
Common Stock | 2,475,000(1) | I | By spouse(4) |
Common Stock | 39,875,000(1) | I | By spouse(5) |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
---|---|---|---|---|---|---|---|
1. Title of Derivative Security (Instr. 4) | 2. Date Exercisable and Expiration Date (Month/Day/Year) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 6. Nature of Indirect Beneficial Ownership (Instr. 5) | ||
Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
Restricted Stock Units | (6) | (6) | Common Stock | 435,407(6) | (6) | D | |
Stock Option (right to buy) | (8) | 10/07/2031 | Common Stock | 330,000(7) | $0.01(7) | D | |
Stock Option (right to buy) | (9) | 02/24/2032 | Common Stock | 275,000(7) | $0.79(7) | D | |
Stock Option (right to buy) | (10) | 07/12/2033 | Common Stock | 550,000(7) | $1.38(7) | D | |
Restricted Stock Units | (11) | (11) | Common Stock | 435,407(11) | (11) | I | By spouse(12) |
Stock Option (right to buy) | (13) | 10/07/2031 | Common Stock | 1,650,000(7) | $0.01(7) | I | By spouse(12) |
Stock Option (right to buy) | (14) | 10/07/2031 | Common Stock | 1,925,000(7) | $0.01(7) | I | By spouse(12) |
Stock Option (right to buy) | (15) | 02/24/2032 | Common Stock | 550,000(7) | $0.79(7) | I | By spouse(12) |
Stock Option (right to buy) | (16) | 07/12/2033 | Common Stock | 2,750,000(7) | $1.38(7) | I | By spouse(12) |
Series A Preferred Stock | (17) | (17) | Common Stock | 929,390(17) | (17) | I | By spouse(12) |
Series A Preferred Stock | (17) | (17) | Common Stock | 100,837(17) | (17) | I | By spouse(18) |
Explanation of Responses: |
1. The number of shares of common stock reported gives effect to the 5.5-to-1 forward stock split, which will occur upon the closing of the issuer's initial public offering. |
2. The securities reported herein are held by Securus Risk Management LLC, which is an entity controlled by the reporting person. The reporting person disclaims beneficial ownership of these securities except to the extent of her pecuniary interest therein, and the inclusion of these shares in this report shall not be deemed an admission of beneficial ownership of all of the reported shares for purposes of Section 16 or for any other purpose. |
3. Represent shares of common stock beneficially owned by the reporting person's spouse. The reporting person disclaims beneficial ownership of these securities except to the extent of her pecuniary interest therein, and the inclusion of these shares in this report shall not be deemed an admission of beneficial ownership of all of the reported shares for purposes of Section 16 or for any other purpose. |
4. Represent shares of common stock beneficially owned by the reporting person's spouse through Bruce Lucas Irrevocable Grantor Retained Annuity Trust of 2014. The reporting person disclaims beneficial ownership of these securities except to the extent of her pecuniary interest therein, and the inclusion of these shares in this report shall not be deemed an admission of beneficial ownership of all of the reported shares for purposes of Section 16 or for any other purpose. |
5. Represent shares of common stock beneficially owned by the reporting person's spouse through IIM Holdings II, LLC. The reporting person disclaims beneficial ownership of these securities except to the extent of her pecuniary interest therein, and the inclusion of these shares in this report shall not be deemed an admission of beneficial ownership of all of the reported shares for purposes of Section 16 or for any other purpose. |
6. Each restricted stock unit represents a contingent right to receive one share of the issuer's common stock. These restricted stock units vest in 24 equal monthly installments commencing on January 1, 2025 and ending on December 31, 2026, subject to the reporting person's continued employment or service through each applicable vesting date. The number of underlying shares of common stock reported gives effect to the 5.5-to-1 forward stock split, which will occur upon the closing of the issuer's initial public offering. |
7. The number of shares of common stock underlying stock options and the applicable exercise price give effect to the 5.5-to-1 forward stock split, which will occur upon the closing of the issuer's initial public offering. |
8. The option vests 25% on September 13, 2022 and in equal monthly installments thereafter ending on September 13, 2025, subject to the reporting person's continued employment or service through each applicable vesting date. |
9. The option vested on December 25, 2023 upon the achievement of applicable performance goals. |
10. Represent vested portion of the option that vests upon the achievement of applicable performance goals. |
11. Each restricted stock unit represents a contingent right to receive one share of the issuer's common stock. These restricted stock units vest in 24 equal monthly installments commencing on January 1, 2025 and ending on December 31, 2026, subject to the recipient's continued employment or service through each applicable vesting date. The number of underlying shares of common stock reported gives effect to the 5.5-to-1 forward stock split, which will occur upon the closing of the issuer's initial public offering. |
12. Represent securities beneficially owned by the reporting person's spouse. The reporting person disclaims beneficial ownership of these securities except to the extent of her pecuniary interest therein, and the inclusion of these securities in this report shall not be deemed an admission of beneficial ownership of all of the reported securities for purposes of Section 16 or for any other purpose. |
13. Include 1,512,500 shares underlying the option that are vested and exercisable. The remaining portion of the option vests in equal monthly installments through September 13, 2025, subject to the reporting person's continued employment or service through each applicable vesting date. |
14. Represent vested portion of the option that vests upon the achievement of applicable performance goals. |
15. The option vested on December 25, 2023 upon the achievement of applicable performance goals. |
16. Represent vested portion of the option that vests upon the achievement of applicable performance goals. |
17. The Series A Preferred Stock is convertible into the issuer's common stock on a one-for-one basis and has no expiration date. All Series A Preferred Stock will be automatically converted into shares of common stock upon the closing of the issuer's initial public offering. The number of underlying shares of common stock reported gives effect to the 5.5-to-1 forward stock split, which will occur upon the closing of the issuer's initial public offering. |
18. Represent securities beneficially owned by the reporting person's spouse through Bruce Lucas Irrevocable Grantor Retained Annuity Trust of 2014. The reporting person disclaims beneficial ownership of these securities except to the extent of her pecuniary interest therein, and the inclusion of these shares in this report shall not be deemed an admission of beneficial ownership of all of the reported shares for purposes of Section 16 or for any other purpose. |
/s/ Jesse Schalk, Attorney-in-Fact for Shannon Lucas | 06/17/2025 | |
** 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 5 (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. |