Jacob Smith - Oct 13, 2021 Form 3 Insider Report for Black Mountain Acquisition Corp. (BMAC)

Signature
/s/ Jacob Smith
Stock symbol
BMAC
Transactions as of
Oct 13, 2021
Transactions value $
$0
Form type
3
Date filed
10/13/2021, 03:44 PM
Next filing
Apr 10, 2023

Derivative Securities (e.g., puts, calls, warrants, options, convertible securities)

Type Sym Class Transaction Value $ Shares Change % * Price $ Shares After Date Underlying Class Amount Exercise Price Ownership Footnotes
holding BMAC Class B Common Stock Oct 13, 2021 Class A Common Stock 5.66M See Footnote F1, F2, F3
* An asterisk sign (*) next to the price indicates that the price is likely invalid.

Explanation of Responses:

Id Content
F1 The Class B Common Stock is convertible into Class A Common Stock of the Issuer on a one-for-one basis, subject to adjustment pursuant to certain anti-dilution rights, and has no expiration date.
F2 Includes up to 750,000 shares of Class B Common Stock that are subject to forfeiture by Black Mountain Sponsor LLC ("Sponsor") depending on the extent to which the underwriters in the Issuer's initial public offering of units exercise their over-allotment option.
F3 Sponsor is the record holder of the securities reported herein. Sponsor is a limited liability company, the sole manager of which is Rhett Bennett, and its members include the Reporting Person. Because of the relationship between the Reporting Person and Sponsor, the Reporting Person may be deemed to beneficially own the securities held of record by Sponsor and reported herein to the extent of the greater of the Reporting Person's direct or indirect pecuniary interests in the profits or capital accounts of Sponsor. The Reporting Person disclaims beneficial ownership of the securities reported herein, except to the extent of the Reporting Person's pecuniary interest therein, if any, and this report shall not be deemed an admission that the Reporting Person is the beneficial owner of or has any pecuniary interest in such securities for purposes of Section 16 of the Securities Exchange Act of 1934, as amended, or for any other purpose.

Remarks:

Chief Financial Officer, Chief Accounting Officer and Secretary Exhibit List: Exhibit 24.1 - Power of Attorney