Ownership Submission
FORM 3 | 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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1. Name and Address of Reporting Person * |
Moak Brandon
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2. Date of Event Requiring Statement (Month/Day/Year)
2021-11-10
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3. Issuer Name and Ticker or Trading Symbol
Embark Technology, Inc. [EMBK]
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(Last)
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(First)
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(Middle)
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C/O EMBARK TECHNOLOGY, INC. , 424 TOWNSEND STREET
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ 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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Chief Tech Officer/Co-Founder /
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5. If Amendment, Date Original Filed(Month/Day/Year)
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(Street)
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SAN FRANCISCO
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CA
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94107
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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)
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
Reporting Owner Name / Address |
Relationships |
Director
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10% Owner
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Officer
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Other
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Moak Brandon
C/O EMBARK TECHNOLOGY, INC.
424 TOWNSEND STREET
SAN FRANCISCO, CA94107
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X
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Chief Tech Officer/Co-Founder
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Signatures
/s/ Siddhartha Venkatesan, Attorney-in-fact for Brandon Moak
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2021-11-18
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**Signature of Reporting Person
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Date
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Explanation of Responses:
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If the form is filed by more than one reporting person, see Instruction 5(b)(v).
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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) |
Shares of the Class B Common Stock may be converted into shares of Class A common stock, on a one-to-one basis, at the option of the holder at any time and have no expiration date.
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(2) |
Restricted Stock Units ("RSUs") vest based on the Issuer's stock price performance over a performance period beginning on the first anniversary of the business combination of NGA and Embark Trucks, and ending on the tenth anniversary of the grant date, subject to satisfying certain service-based conditions. The award will vest, if at all, in six equal tranches based on the Issuer's stock price exceeding certain thresholds. Any portion of the award that has not been earned by the tenth anniversary of the award grant date will be forfeited.
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(3) |
Each RSU represents a contingent right to receive a Class A Common Stock of the Issuer.
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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.
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Northern Genesis Acquisition Corp. II published this content on 18 November 2021 and is solely responsible for the information contained therein. Distributed by Public, unedited and unaltered, on 18 November 2021 23:12:13 UTC.