Sec Form 3 Filing - Aguirre Miriam @ Skillz Inc. - 2020-12-16

Insider filing report for Changes in Beneficial Ownership
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FORM 3
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
Aguirre Miriam
2. Issuer Name and Ticker or Trading Symbol
Skillz Inc. [ SKLZ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director _____ 10% Owner
X __ Officer (give title below) _____ Other (specify below)
Chief Technology Officer
(Last) (First) (Middle)
C/O SKILLZ INC., P.O. BOX 445
3. Date of Earliest Transaction (MM/DD/YY)
12/16/2020
(Street)
SAN FRANCISCO, CA94104-0445
4. If Amendment, Date Original Filed (MM/DD/YY)
6. Individual or Joint/Group Filing (Check Applicable Line)
__ X __ Form filed by One Reporting Person
_____ 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
Class A Common Stock 359,564 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
Stock Options (right to buy) $ 0.04 ( 1 ) 07/13/2026 Class A common stock 1,334,664 D
Stock Options (right to buy) $ 0.43 ( 2 ) 04/24/2029 Class A common stock 291,369 D
Stock Options (right to buy) $ 1.33 ( 3 ) 06/07/2030 Class A common stock 1,520,736 D
Stock Options (right to buy) $ 1.33 12/16/2020 06/07/2030 Class A common stock 919,862 D
Earn-Out Shares $ 0 ( 4 ) 12/16/2025 Class A common stock 6,692 D
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Aguirre Miriam
C/O SKILLZ INC.
P.O. BOX 445
SAN FRANCISCO, CA94104-0445
Chief Technology Officer
Signatures
/s/ Charlotte Edelman, Attorney-in-Fact 12/18/2020
Signature of Reporting Person Date
Explanation of Responses:
( 1 )Twenty-five percent of the stock option grant vests on April 29, 2020 and the remainder vests in quarterly increments thereafter.
( 2 )Twenty-five percent of the stock option grant vests on August 1, 2017 and the remainder vests in quarterly increments thereafter.
( 3 )Twenty-five percent of the stock option grant vests on August 1, 2021 and the remainder vests in quarterly increments thereafter.
( 4 )On December 16, 2020 (the "Closing Date"), the Reporting Person received the right to acquire 6,692 shares of the Issuer's Class A Common Stock in connection with the Issuer's business combination, (i) one-half of which will be released from escrow if (a) the VWAP for at least 20 of any 30 consecutive trading days following the Closing Date is at least $15.00 or (b) the Issuer consummates a transaction resulting in its stockholders being able to exchange their shares for cash, securities or other property with a per share value ("Qualifying Value") of at least $15.00; and (ii) one-half if (a) the VWAP for at least 20 of any 30 consecutive trading days following the Closing Date is at least $17.50 or (b) the Issuer consummates a transaction with a Qualifying Value of at least $17.50. Any shares not eligible to be released within five years of the Closing Date will be forfeited and canceled.

Remarks:
See Exhibit 24.1 - Power of Attorney

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