FORM 4
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
☐ Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan that is intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10. |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 |
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1. Name and Address of Reporting Person * Parks Jeffrey T | 2. Issuer Name and Ticker or Trading Symbol Vacasa, Inc. [ VCSA ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director __X__ 10% Owner _____ Officer (give title below) _____ Other (specify below) |
3. Date of Earliest Transaction
(MM/DD/YYYY)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
___ Form filed by One Reporting Person
_ X _ Form filed by More than One Reporting Person | |
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | ||||||||||
1.Title of Security (Instr. 3) | 2. Trans. Date | 2A. Deemed Execution Date, if any |
3. Trans. 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 (1)(2) | 5/21/2024 | A | 20,134 (3) | A | $0 | 30,380 | D (4) | |||
Class A Common Stock | 825,103 | I | Held through RW Industrious Blocker L.P. (5) | |||||||
Class A Common Stock | 34,784 | I | Held through RCP III (A) Blocker Feeder L.P. (6) | |||||||
Class A Common Stock | 277,833 | I | Held through RCP III Blocker Feeder L.P. (6) | |||||||
Class A Common Stock | 6,787 | I | Held through RW Vacasa AIV L.P. (5) | |||||||
Class A Common Stock | 3,766 | I | Held through Riverwood Capital Partners II (Parallel-B) L.P. (5) | |||||||
Class A Common Stock | 2,199 | I | Held through RCP III Vacasa AIV L.P. (6) | |||||||
Class A Common Stock | 669 | I | Held through RCP III (A) Vacasa AIV L.P. (6) | |||||||
Class A Common Stock | 1,649 | I | Held through Riverwood Capital Partners III (Parallel-B) L.P. (6) |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||||||||||
1. Title of Derivate Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Trans. Date | 3A. Deemed Execution Date, if any | 4. Trans. 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 | 7. Title and Amount of Securities Underlying Derivative Security (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 |
Remarks: Ownership reported in this Form 4 filing reflects the 1-for-20 reverse stock split completed on October 2, 2023. Due to the limitations of the electronic filing system certain Reporting Persons are filing a separate Form 4. The Reporting Persons are jointly filing this Form 4 pursuant to Rule 16a-3(j) under the Exchange Act. |
Reporting Owners | |||||
Reporting Owner Name / Address | |||||
Director | 10% Owner | Officer | Other | ||
Parks Jeffrey T 70 WILLOW ROAD, SUITE 100 MENLO PARK, CA 94025 | X | X | |||
RCP III (A) Blocker Feeder L.P. 70 WILLOW ROAD, SUITE 100 MENLO PARK, CA 94025 | X | ||||
Riverwood Capital II L.P. 70 WILLOW ROAD, SUITE 100 MENLO PARK, CA 94025 | X | ||||
Riverwood Capital III L.P. 70 WILLOW ROAD, SUITE 100 MENLO PARK, CA 94025 | X | ||||
Riverwood Capital GP II Ltd. 70 WILLOW ROAD, SUITE 100 MENLO PARK, CA 94025 | X | ||||
Riverwood Capital GP III Ltd. 70 WILLOW ROAD, SUITE 100 MENLO PARK, CA 94025 | X | ||||
RW Industrious Blocker L.P. 70 WILLOW ROAD, SUITE 100 MENLO PARK, CA 94025 | X | ||||
RCP III Blocker Feeder L.P. 70 WILLOW ROAD, SUITE 100 MENLO PARK, CA 94025 | X | ||||
RW Vacasa AIV L.P. 70 WILLOW ROAD, SUITE 100 MENLO PARK, CA 94025 | X | ||||
RCP III Vacasa AIV L.P. 70 WILLOW ROAD, SUITE 100 MENLO PARK, CA 94025 | X |
Signatures | ||
By: /s/ Jeffrey T. Parks, Director of Riverwood Capital GP II Ltd., general partner of Riverwood Capital II L.P., general partner of RW Industrious Blocker L.P. | 5/23/2024 | |
**Signature of Reporting Person | Date | |
By: /s/ Jeffrey T. Parks, Director of Riverwood Capital GP II Ltd., general partner of Riverwood Capital II L.P., general partner of RW Vacasa AIV L.P. | 5/23/2024 | |
**Signature of Reporting Person | Date | |
By: /s/ Jeffrey T. Parks, Director of Riverwood Capital GP III Ltd., general partner of Riverwood Capital III L.P., general partner of RCP III (A) Blocker Feeder L.P. | 5/23/2024 | |
**Signature of Reporting Person | Date | |
By: /s/ Jeffrey T. Parks, Director of Riverwood Capital GP III Ltd., general partner of Riverwood Capital III L.P., general partner of RCP III Blocker Feeder L.P. | 5/23/2024 | |
**Signature of Reporting Person | Date | |
By: /s/ Jeffrey T. Parks, Director of Riverwood Capital GP III Ltd., general partner of Riverwood Capital III L.P., general partner of RCP III Vacasa AIV L.P. | 5/23/2024 | |
**Signature of Reporting Person | Date | |
By: /s/ Jeffrey T. Parks, Director of Riverwood Capital GP II Ltd., general partner of Riverwood Capital II L.P. | 5/23/2024 | |
**Signature of Reporting Person | Date | |
By: /s/ Jeffrey T. Parks, Director of Riverwood Capital GP III Ltd., general partner of Riverwood Capital III L.P. | 5/23/2024 | |
**Signature of Reporting Person | Date | |
By: /s/ Jeffrey T. Parks, Director of Riverwood Capital GP II Ltd. | 5/23/2024 | |
**Signature of Reporting Person | Date | |
By: /s/ Jeffrey T. Parks, Director of Riverwood Capital GP III Ltd. | 5/23/2024 | |
**Signature of Reporting Person | Date | |
By: /s/ Jeffrey T. Parks | 5/23/2024 | |
**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 4(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. |
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