Ownership Submission
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FORM 3
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549INITIAL 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
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OMB APPROVAL
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OMB Number:3235-0104Expires:January 31, 2005Estimated average burden hours per response...0.5
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1. Name and Address of Reporting Person *
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Meads Garner B. III
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2. Date of Event Requiring Statement (Month/Day/Year)
2021-12-02
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3. Issuer Name and Ticker or Trading Symbol
Vivint Smart Home, Inc. [VVNT]
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(Last)
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(First)
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(Middle)
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C/O VIVINT SMART HOME, INC. , 4931 NORTH 300 WEST
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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_____ Director
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_____ 10% Owner
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_____ Officer (give title below)
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_____ Other (specify below)
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See Remarks /
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5. If Amendment, Date Original Filed(Month/Day/Year)
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6. Individual or Join/Group Filing(Check Applicable Line)
_X_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Beneficially Owned
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1.Title of Security
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2. Amount of Securities Beneficially Owned
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3. Ownership Form: Direct (D) or Indirect (I)
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4. Nature of Indirect Beneficial Ownership
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Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security
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2. Date Exercisable and Expiration Date
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3. Title and Amount of Securities Underlying Derivative Security
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4. Conversion or Exercise Price of Derivative Security
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5. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
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6. Nature of Indirect Beneficial Ownership
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Date Exercisable
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Expriation Date
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Title
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Amount or Number of Shares
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Reporting Owners
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Reporting Owner Name / Address
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Relationships
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Director
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10% Owner
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Officer
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Other
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Meads Garner B. III
C/O VIVINT SMART HOME, INC.
4931 NORTH 300 WEST
PROVO, UT84604
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See Remarks
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Signatures
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/s/ Garner B. Meads, III
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2021-12-06
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**Signature of Reporting Person
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Date
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Explanation of Responses:
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(*)
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If the form is filed by more than one reporting person, see Instruction 5(b)(v).
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(**)
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Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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(1)
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Represents unvested restricted stock units which will vest in three equal installments on March 1, 2022, 2023 and 2024, and upon vesting, will each be settled by delivery of one share of Class A common stock of the Issuer ("Class A Common Stock") or cash.
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(2)
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Represents unvested restricted stock units granted on March 25, 2021, which will vest in four equal annual installments beginning on the first anniversary of the grant date and upon vesting, will each be settled by delivery of one share of Class A Common Stock or cash.
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(3)
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Represents unvested restricted stock units granted on August 12, 2021, which will vest in four equal annual installments beginning on the first anniversary of the grant date and upon vesting, will each be settled by delivery of one share of Class A Common Stock or cash.
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(4)
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These stock appreciation rights are fully vested.
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(5)
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These stock appreciation rights are fully vested.
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(6)
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Reflects performance-based restricted stock units previously granted to the Reporting Person, the performance condition of which was deemed satisfied on March 1, 2021. Of the performance-based restricted stock units deemed acquired on March 1, 2021, 5,975 vested immediately and the remaining 5,976 will vest on March 1, 2022. Each vested performance-based restricted stock unit will be settled by delivery of one share of Class A Common Stock or cash.
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Note: File three copies of this Form, one of which must be manually signed. If space is insufficient,
See Instruction 6 for procedure.Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB number.
