Sec Form 4 Filing - Curo Financial Technologies Corp. @ Katapult Holdings, Inc. - 2021-06-09

Insider filing report for Changes in Beneficial Ownership
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FORM 4
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
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
Curo Financial Technologies Corp.
2. Issuer Name and Ticker or Trading Symbol
Katapult Holdings, Inc. [ FSRV]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X __ Director X __ 10% Owner
_____ Officer (give title below) _____ Other (specify below)
(Last) (First) (Middle)
3527 NORTH RIDGE ROAD
3. Date of Earliest Transaction (MM/DD/YY)
06/09/2021
(Street)
WICHITA, KS67205
4. If Amendment, Date Original Filed (MM/DD/YY)
6. Individual or Joint/Group Filing (Check Applicable Line)
_____ Form filed by One Reporting Person
__ X __ Form filed by More than One Reporting Person
(City) (State) (Zip)
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1.Title of Security
(Instr. 3)
2. Transaction Date (MM/DD/YY) 2A. Deemed Execution Date, if any (MM/DD/YY) 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
Common Stock 06/09/2021 J( 1 ) 21,892,864 ( 2 ) A $ 0 ( 1 ) 21,892,864 ( 2 ) ( 3 ) D
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 (MM/DD/YY) 3A. Deemed Execution Date, if any (MM/DD/YY) 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
(MM/DD/YY)
7. Title and Amount of Underlying Securities
(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
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Curo Financial Technologies Corp.
3527 NORTH RIDGE ROAD
WICHITA, KS67205
X X
CURO Group Holdings Corp.
3527 NORTH RIDGE ROAD
WICHITA, KS67205
X X
Signatures
/s/ Vin Thomas 06/14/2021
Signature of Reporting Person Date
Explanation of Responses:
( 1 )Shares were acquired pursuant to Katapult Holdings, Inc's (the "Issuer") initial business combination in exchange for shares of the legacy Katapult Holdings, Inc. entity that were owned by the Reporting Person prior to the Closing.
( 2 )Includes earn out shares granted in connection with the Issuer's initial business combination, subject to certain vesting provisions.
( 3 )Solely for purposes of Section 16 of the Securities Exchange Act of 1934, each of Curo Financial Technologies Corp. and Curo Group Holdings Corp. (the "Reporting Persons"), may be deemed to be directors-by-deputization by virtue of their right to designate two members of the board of directors of the Issuer. The Reporting Persons designated Don Gayhardt and Chris Masto, as members of the board of directors of the Issuer. Each Reporting Person expressly disclaims beneficial ownership of the shares except to the extent of such Reporting Person's pecuniary interest therein.

Remarks:
Exhibit List:Exhibit 99.1 - Joint Filers' Names and AddressesExhibit 99.2 - Joint Filers' Signatures

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* If the form is filed by more than one reporting person, see Instruction 4(b)(v).
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