Initial Statement of Beneficial Ownership (3)
January 03 2022 - 4:16PM
Edgar (US Regulatory)
FORM 3
|
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
|
OMB APPROVAL
OMB Number:
3235-0104
Estimated average burden
hours per response...
0.5
|
|
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
*
Deckmann Natasha |
2. Date of Event Requiring Statement (MM/DD/YYYY)
12/27/2021
|
3. Issuer Name and Ticker or Trading Symbol
Senior Connect Acquisition Corp. I [SNRH]
|
|
(Last)
(First)
(Middle)
C/O SENIOR CONNECT ACQUISITION CORP. I, 7114 EAST STETSON DRIVE, SUITE 400 |
4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
__X__ Director _____ 10% Owner
_____ Officer (give title below) _____ Other (specify below)
|
|
(Street)
SCOTTSDALE, AZ 85251
(City)
(State)
(Zip)
| 5. If Amendment, Date Original Filed(MM/DD/YYYY)
| 6. Individual or Joint/Group Filing(Check Applicable Line)
_X_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
|
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) |
| Units (1) | 3850 | D | |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
|
1. Title of Derivate Security
(Instr. 4) | 2. Date Exercisable and Expiration Date
(MM/DD/YYYY) | 3. Title and Amount of Securities Underlying Derivative Security
(Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form of Derivative Security: 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 |
| Explanation of Responses: |
| (1) | The units of the Issuer are as described under the heading "Description of Securities" in the Issuer's Registration Statement on Form S-1 (File No. 333-250932) (the "Registration Statement") and each unit has an offering price of $10.00 and consists of one share of Class A common stock and one-half of one redeemable warrant. |
Remarks:
See Exhibit 24.1 - Power of Attorney. |
Reporting Owners
|
| Reporting Owner Name / Address | Relationships |
| Director | 10% Owner | Officer | Other |
Deckmann Natasha
C/O SENIOR CONNECT ACQUISITION CORP. I
7114 EAST STETSON DRIVE, SUITE 400
SCOTTSDALE, AZ 85251 | X |
|
|
|
Signatures
|
| /s/ Audrey Bae, Attorney-in-Fact | | 1/3/2022 |
| **Signature of Reporting Person | Date |
Senior Connect Acquisiti... (NASDAQ:SNRH)
Historical Stock Chart
From Dec 2024 to Jan 2025
Senior Connect Acquisiti... (NASDAQ:SNRH)
Historical Stock Chart
From Jan 2024 to Jan 2025
