Parth Mehrotra - Dec 31, 2021 Form 5 Insider Report for Privia Health Group, Inc. (PRVA)

Role
President and COO
Signature
/s/ Thomas Bartrum, attorney-in-fact
Stock symbol
PRVA
Transactions as of
Dec 31, 2021
Transactions value $
$0
Form type
5
Date filed
2/14/2022, 08:56 AM
Previous filing
Dec 23, 2021
Next filing
Feb 14, 2022

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 PRVA Stock Option (Right to Purchase) Gift $0 -339K -45.16% $0.00 412K Sep 24, 2021 Common Stock 339K $2.00 Direct F1, F2, F3
transaction PRVA Stock Option (Right to Purchase) Gift $0 -104K -60% $0.00 69.5K Sep 24, 2021 Common Stock 104K $2.00 Direct F1, F2, F4
transaction PRVA Stock Option (Right to Purchase) Gift $0 +339K $0.00 339K Sep 24, 2021 Common Stock 339K $2.00 By the Parth Mehrotra 2021 Trust F1, F2
transaction PRVA Stock Option (Right to Purchase) Gift $0 +104K $0.00 104K Sep 24, 2021 Common Stock 104K $2.00 By the Parth Mehrotra 2021 Trust F1, F2
* An asterisk sign (*) next to the price indicates that the price is likely invalid.

Explanation of Responses:

Id Content
F1 On September 24, 2021, the reporting person transferred options to purchase shares of the Issuer's common stock to a trust of which the spouse of the reporting person is trustee. The reporting person's spouse and children are the sole beneficiaries of the trust.
F2 All of the transferred stock options are fully vested and exercisable.
F3 139,330 of the stock options are fully vested and exercisable. 46,445 of the stock options will vest and become exercisable on December 4, 2022, 113,065 of the stock options will vest and become exercisable on the 12 month anniversary of the Issuer's initial public offering and 113,067 of the stock options will vest and become exercisable on the 18 month anniversary of the Issuer's initial public offering.
F4 34,739 of the stock options will vest and become exercisable on the 12 month anniversary of the Issuer's initial public offering and 34,739 of the stock options will vest and become exercisable on the 18 month anniversary of the Issuer's initial public offering.