1. Name and Address of Reporting Person*
(Street)
|
2. Date of Event Requiring Statement
(Month/Day/Year) 08/07/2019
|
3. Issuer Name and Ticker or Trading Symbol
Vericity, Inc.
[ VERY ]
|
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
|
Director |
X |
10% Owner |
|
Officer (give title below) |
|
Other (specify below) |
|
|
5. If Amendment, Date of Original Filed
(Month/Day/Year)
|
6. Individual or Joint/Group Filing (Check Applicable Line)
|
Form filed by One Reporting Person |
X |
Form filed by More than One Reporting Person |
|
1. Name and Address of Reporting Person*
(Street)
|
1. Name and Address of Reporting Person*
C/O J.C. FLOWERS & CO. LLC |
767 FIFTH AVENUE, 23RD FLOOR |
(Street)
|
1. Name and Address of Reporting Person*
C/O J.C. FLOWERS & CO. LLC |
767 FIFTH AVENUE, 23RD FLOOR |
(Street)
|
1. Name and Address of Reporting Person*
C/O J.C. FLOWERS & CO. LLC |
767 FIFTH AVENUE, 23RD FLOOR |
(Street)
|
1. Name and Address of Reporting Person*
717 FIFTH AVENUE |
26TH FLOOR |
(Street)
|
|
Apex Holdco L.P.
By: /s/Todd Freebern |
08/07/2019 |
|
Apex Holdco GP LLC
By: /s/ Eric Rahe
Name: Eric Rahe
Title: Vice President |
08/07/2019 |
|
JCF Associates IV L.P.
By: /s/ J. Christopher Flowers
Name: J. Christopher Flowers
Title: Director |
08/07/2019 |
|
JCF Associates IV Ltd.
By: /s/ J. Christopher Flowers
Name: J. Christopher Flowers
Title: Director |
08/07/2019 |
|
/s/ J. Christopher Flowers |
08/07/2019 |
|
** 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
5
(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. |
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |