CUSIP No. 58450V104
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13D
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Page 3 of 9 |
1
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NAMES OF REPORTING PERSONS
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Jason Heiling
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2
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CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP
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(a)
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☐
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(b)
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■*
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3
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SEC USE ONLY
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4
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SOURCE OF FUNDS (SEE INSTRUCTIONS)
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OO |
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5
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CHECK BOX IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT TO ITEM 2(D) OR 2(E)
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☐
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6
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CITIZENSHIP OR PLACE OF ORGANIZATION
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United States
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NUMBER OF SHARES BENEFICIALLY OWNED BY EACH REPORTING PERSON WITH
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7
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SOLE VOTING POWER
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3,923,885**
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8
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SHARED VOTING POWER
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0 |
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9
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SOLE DISPOSITIVE POWER
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3,923,885**
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10
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SHARED DISPOSITIVE POWER
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0 |
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11
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AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
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3,923,885**
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12
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CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN SHARES (SEE INSTRUCTIONS)
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☐
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13
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PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11)
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9.2%**
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14
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TYPE OF REPORTING PERSON (SEE INSTRUCTIONS)
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OO
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* |
The Reporting Person may be deemed to be part of a group pursuant to that certain Stockholders Agreement described in Item 6 of the Schedule 13D but each Reporting Person disclaims beneficial ownership of the Common Stock held by the
other members of the group.
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** |
Represents 3,923,885 shares of Class B Common Stock (which, along with corresponding Class B-1 units), may from time to time be exchanged on a one-for-one basis for Class A Common Stock). Determination of the percentage of beneficial
ownership of the Reporting Person is based on 38,623,954 shares of Class A Common Stock reported to be outstanding as of April 30, 2021 as disclosed in MediaAlpha, Inc.’s Quarterly Report on Form 10-Q for the period ended March 31, 2021
filed with the SEC on May 14, 2021. By virtue of his role as manager of OBF Investments, Mr. Heiling may be deemed to have sole power to vote and dispose of the shares reported owned by OBF Investments.
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CUSIP No. 58450V104
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13D
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Page 4 of 9 |
1
|
NAMES OF REPORTING PERSONS
|
|
|
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OBF Investments, LLC
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|
|
|||
|
|
||||
2
|
CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP
|
(a)
|
☐
|
||
(b)
|
■
|
||||
|
|
||||
3
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SEC USE ONLY
|
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||
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|||
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||||
4
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SOURCE OF FUNDS (SEE INSTRUCTIONS)
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OO |
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|
|||
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|
||||
5
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CHECK BOX IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT TO ITEM 2(D) OR 2(E)
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☐
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6
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CITIZENSHIP OR PLACE OF ORGANIZATION
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Nevada
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NUMBER OF SHARES BENEFICIALLY OWNED BY EACH REPORTING PERSON WITH
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7
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SOLE VOTING POWER
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|
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3,923,885**
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|
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|||
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|
||||
8
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SHARED VOTING POWER
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|
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||
0 |
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|
|||
|
|
||||
9
|
SOLE DISPOSITIVE POWER
|
|
|
||
3,923,885**
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|
|
|||
|
|
||||
10
|
SHARED DISPOSITIVE POWER
|
|
|
||
0 |
|
|
|||
|
|
||||
11
|
AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
|
|
|
||
3,923,885**
|
|
|
|||
|
|
||||
12
|
CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN SHARES (SEE INSTRUCTIONS)
|
|
☐
|
||
|
|
||||
|
|
||||
13
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PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11)
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9.2%** |
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|||
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||||
14
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TYPE OF REPORTING PERSON (SEE INSTRUCTIONS)
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||
OO |
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|
|||
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|
* |
The Reporting Person may be deemed to be part of a group pursuant to that certain Stockholders Agreement described in Item 6 of the Schedule 13D but each Reporting Person disclaims beneficial ownership of the Common Stock held by the
other members of the group.
|
** |
Represents 3,923,885 shares of Class B Common Stock (which, along with corresponding Class B-1 units), may from time to time be exchanged on a one-for-one basis for Class A Common Stock). Determination of the percentage of beneficial
ownership of the Reporting Person is based on 38,623,954 shares of Class A Common Stock reported to be outstanding as of April 30, 2021 as disclosed in MediaAlpha, Inc.’s Quarterly Report on Form 10-Q for the period ended March 31, 2021
filed with the SEC on May 14, 2021.
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CUSIP No. 58450V104
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13D
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Page 5 of 9 |
Item 1. |
Security and Issuer.
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Item 2. |
Identity and Background.
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CUSIP No. 58450V104
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13D
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Page 6 of 9 |
Item 3. |
Source and Amount of Funds or Other Consideration.
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Item 4. |
Purpose of Transaction.
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Item 5. |
Interest in Securities of the Issuer.
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CUSIP No. 58450V104
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13D
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Page 7 of 9 |
Item 6. |
Contracts, Arrangements, Understandings or Relationships with Respect to Securities of Issuer.
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● |
offer, pledge, sell, contract to sell, sell any option or contract to purchase, purchase any option or contract to sell, grant any option, right or warrant to purchase, lend, or otherwise transfer or dispose of, directly or indirectly,
any shares of our common stock beneficially owned by them or any other securities so owned that are convertible into or exercisable or exchangeable for shares of our common stock;
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● |
file any registration statement with the SEC relating to the offering of any shares of common stock or any securities convertible into or exercisable or exchangeable for shares of common stock; or
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enter into any swap or other arrangement that transfers to another, in whole or in part, any of the economic consequences of ownership of shares of our common stock,
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CUSIP No. 58450V104
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13D
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Page 8 of 9 |
Item 7. |
Material to Be Filed as Exhibits.
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CUSIP No. 58450V104
|
13D
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Page 9 of 9 |
By:
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/s/ Jason Heiling |
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Name:
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Jason Heiling
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By: OBF Investments, LLC
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||||
By:
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/s/ Jason Heiling |
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Name:
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Jason Heiling
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Title:
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Manager
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