SEC FORM 3 SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL 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*
FRESENIUS MEDICAL CARE HOLDINGS INC /NY/

(Last) (First) (Middle)
920 WINTER STREET

(Street)
WALTHAM MA 02451-1547

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
08/26/2021
3. Issuer Name and Ticker or Trading Symbol
Humacyte, Inc. [ HUMA ]
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)
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)
Common Stock, par value $0.0001 per share 18,312,735(1) D(2)
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: 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. Excludes the Reporting Person's pro rata share of up to 15,000,000 additional shares of the Issuer's Common Stock which may become issuable to the former shareholders of Humacyte, Inc. pursuant to the terms of the Business Combination Agreement dated as of February 17, 2021 by and among the Issuer, Hunter Merger Sub, Inc. and Humacyte, Inc., as to which the Reporting Person disclaims any present beneficial ownership interest.
2. Fresenius Medical Care Holdings, Inc. is an indirect, wholly-owned subsidiary of Fresenius Medical Care AG & Co. KGaA ("FMC AG & Co. KGaA"). FMC AG & Co. KGaA's address is Else-Kroner Strasse 1, 61352 Bad Homburg, Germany.
FRESENIUS MEDICAL CARE HOLDINGS, INC. /s/ Mark Fawcett By: Mark Fawcett Senior Vice President and Treasurer 09/02/2021
** 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.
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