Bloom Retirement Holdings Inc. - 29 Dec 2023 Form 4 Insider Report for Finance of America Companies Inc. (FOA)

Role: 10%+ Owner
Signature: Bloom Retirement Holdings Inc., By: /s/ Reza Jahangiri, its majority shareholder
Issuer symbol: FOA
Transactions as of: 29 Dec 2023
Net transactions value: $0
Form type: 4
Filing time: 03 Jan 2024, 16:30:51 UTC
Previous filing: 10 Apr 2023
SEC: View on sec.gov

Transactions Table

Type	Sym	Class	Transaction	Value $	Shares	Change %	* Price $	Shares After	Date	Ownership	Footnotes
transaction	FOA	Class A Common Stock	Conversion of derivative security		+8,000,000			8,000,000	29 Dec 2023	See footnote	F1, F2

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
transaction	FOA	FOAEC Units	Conversion of derivative security	$0	-8,000,000	-24%	$0.000000	25,893,666	29 Dec 2023	Class A Common Stock	8,000,000		See footnote	F1, F2

* An asterisk sign (*) next to the price indicates that the price is likely invalid.

Explanation of Responses:

Id	Content
F1	Each limited liability company unit of Finance of America Equity Capital LLC (the "FOAEC Unit") is exchangeable for one share of Class A Common Stock of the Issuer at the option of the holder. The FOAEC Units do not expire.
F2	Bloom Retirement Holdings Inc. is the record holder of the securities reported herein. Reza Jahangiri is the majority shareholder of Bloom Retirement Holdings Inc. As such, Mr. Jahangiri may be deemed to share voting and dispositive power over the securities held by Bloom Retirement Holdings Inc.