Form 4 - Statement of changes in beneficial ownership of securities
17 7월 2024 - 5:41AM
Edgar (US Regulatory)
SEC Form 4
FORM 4 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
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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OMB APPROVAL |
OMB Number: |
3235-0287 |
Estimated average burden |
hours per response: |
0.5 |
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue.
See
Instruction 1(b). |
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Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan for the purchase or sale of equity securities of the issuer that is intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10. |
1. Name and Address of Reporting Person*
C/O CONNECTM TECHNOLOGY SOLUTIONS, INC. |
2 MOUNT ROYAL AVE., SUITE 550 |
(Street)
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2. Issuer Name and Ticker or Trading Symbol
ConnectM Technology Solutions, Inc.
[ CNTM ]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X |
Director |
X |
10% Owner |
X |
Officer (give title below) |
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Other (specify below) |
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See Remarks |
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3. Date of Earliest Transaction
(Month/Day/Year) 07/12/2024
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4. If Amendment, Date of Original Filed
(Month/Day/Year)
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6. Individual or Joint/Group Filing (Check Applicable Line)
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Form filed by One Reporting Person |
X |
Form filed by More than One Reporting Person |
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned |
1. Title of Security (Instr.
3)
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2. Transaction Date
(Month/Day/Year) |
2A. Deemed Execution Date, if any
(Month/Day/Year) |
3. Transaction Code (Instr.
8)
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4. Securities Acquired (A) or Disposed Of (D) (Instr.
3, 4 and 5)
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5.
Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr.
3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr.
4)
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7. Nature of Indirect Beneficial Ownership (Instr.
4)
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Code |
V |
Amount |
(A) or (D) |
Price |
Class A Common Stock |
07/12/2024 |
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C
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1,625,000 |
A |
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1,625,000 |
I |
See Footnote
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Class A Common Stock |
07/12/2024 |
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J
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1,625,000 |
D |
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0 |
I |
See Footnote
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Common Stock |
07/12/2024 |
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J
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1,625,000 |
A |
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1,625,000 |
I |
See Footnote
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Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivative Security (Instr.
3)
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2. Conversion or Exercise Price of Derivative Security
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3. Transaction Date
(Month/Day/Year) |
3A. Deemed Execution Date, if any
(Month/Day/Year) |
4. Transaction Code (Instr.
8)
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5.
Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr.
3, 4 and 5)
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6. Date Exercisable and Expiration Date
(Month/Day/Year) |
7. Title and Amount of Securities Underlying Derivative Security (Instr.
3 and 4)
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8. Price of Derivative Security (Instr.
5)
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9.
Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr.
4)
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10. Ownership Form: Direct (D) or Indirect (I) (Instr.
4)
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11. Nature of Indirect Beneficial Ownership (Instr.
4)
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Code |
V |
(A) |
(D) |
Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
Class B Common Stock |
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07/12/2024 |
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C
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|
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1,625,000 |
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Class A Common Stock |
1,625,000 |
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0 |
I |
See Footnote
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Warrants (Right to Buy) |
$11.5
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07/12/2024 |
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J
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3,040,000 |
|
07/12/2024 |
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Class A Common Stock |
3,040,000 |
$1
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3,040,000 |
I |
See Footnote
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Warrants (Right to Buy) |
$11.5
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07/12/2024 |
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J
|
|
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3,040,000 |
07/12/2024 |
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Class A Common Stock |
3,040,000 |
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0 |
I |
See Footnote
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Warrants (Right to Buy) |
$11.5
|
07/12/2024 |
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J
|
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3,040,000 |
|
07/12/2024 |
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Common Stock |
3,040,000 |
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3,040,000 |
I |
See Footnote
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Warrants (Right to Buy) |
$11.5
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07/12/2024 |
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J
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750,000 |
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07/12/2024 |
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Common Stock |
750,000 |
$1
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3,790,000 |
I |
See Footnote
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1. Name and Address of Reporting Person*
C/O CONNECTM TECHNOLOGY SOLUTIONS, INC. |
2 MOUNT ROYAL AVE., SUITE 550 |
(Street)
Relationship of Reporting Person(s) to Issuer
X |
Director |
X |
10% Owner |
X |
Officer (give title below) |
|
Other (specify below) |
|
See Remarks |
|
|
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
|
Director |
X |
10% Owner |
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Officer (give title below) |
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Other (specify below) |
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|
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Explanation of Responses: |
Remarks: |
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/s/ Bhaskar Panigrahi, Attorney-in-Fact |
07/16/2024 |
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** 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
4
(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. |
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |
Exhibit 24.1
LIMITED
POWER OF ATTORNEY
July 12, 2024
Know all by these presents, that the undersigned
hereby makes, constitutes and appoints each of Bhaskar Panigrahi and Mahesh Choudhury of the Company and Shashi Khiani, Caroline Steck
and Nicholas Penn of Polsinelli PC as the undersigned’s true and lawful attorney-in-fact, with full power and authority as hereinafter
described on behalf of and in the name, place and stead of the undersigned to:
| 1. | Prepare, execute, acknowledge, deliver and file Forms 144, Schedules 13G or 13D, and Forms 3, 4, and 5
(including any amendments thereto), including applications for Form ID, and any actions or documents necessary to facilitate the
timely filing of notices of proposed sales and beneficial ownership reports, with respect to the securities of ConnectM Technology Solutions, Inc.,
a Delaware corporation (the “Company”), with the United States Securities and Exchange Commission, any national securities
exchanges and the Company, as considered necessary or advisable under Rule 144 promulgated under the Securities Act of 1933, as amended
from time to time (the “Securities Act”) and/or Sections 13(d) and 16(a) of the Securities Exchange Act of 1934
and the rules and regulations promulgated thereunder, as amended from time to time (the “Exchange Act”); |
| 2. | Seek or obtain, as the undersigned’s representative and on the undersigned’s behalf, information
on transactions in the Company’s securities from any third party, including brokers, employee benefit plan administrators and trustees,
and the undersigned hereby authorizes any such person to release any such information to the undersigned and approves and ratifies any
such release of information; and |
| 3. | Perform any and all other acts which in the discretion of the attorney-in-fact are necessary or desirable
for and on behalf of the undersigned in connection with the foregoing. |
The undersigned acknowledges that:
| 1. | This Limited Power of Attorney authorizes, but does not require, each attorney-in-fact to act in his or
her discretion on information provided to each such attorney-in-fact without independent verification of such information; |
| 2. | Any documents prepared and/or executed by an attorney-in-fact on behalf of the undersigned pursuant to
this Limited Power of Attorney will be in such form and will contain such information and disclosure as each such attorney-in-fact, in
his or her discretion, deems necessary or desirable; |
| 3. | None of the Company or any such attorney-in-fact assumes (i) any liability for the undersigned’s
responsibility to comply with the requirements of the Exchange Act, (ii) any liability of the undersigned for any failure to comply
with such requirements, or (iii) any obligation or liability of the undersigned for profit disgorgement under Section 13 or
16 of the Exchange Act; and |
| 4. | This Limited Power of Attorney does not relieve the undersigned from responsibility for compliance with
the undersigned’s obligations under the Securities Act or the Exchange Act, including without limitation the reporting requirements
under Rule 144 under the Securities Act or Sections 13(d) and 16 of the Exchange Act. The undersigned hereby gives and grants
each attorney-in-fact full power and authority to do and perform all and every act and thing whatsoever requisite, necessary or appropriate
to be done in and about the foregoing matters as fully to all intents and purposes as the undersigned might or could do if present, hereby
ratifying all that each such attorney-in-fact of, for and on behalf of the undersigned, shall lawfully do or cause to be done by virtue
of this Limited Power of Attorney. |
This Limited Power of Attorney shall remain in
full force and effect until revoked by the undersigned in a signed writing delivered to each attorney-in-fact.
IN WITNESS WHEREOF, the undersigned hereto has
caused this Limited Power of Attorney to be duly executed as of the day and year first above written.
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By: |
/s/ Bala Padmakumar |
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Name: |
Bala Padmakumar |
Exhibit 24.2
LIMITED
POWER OF ATTORNEY
July 12, 2024
Know all by these presents, that the undersigned
hereby makes, constitutes and appoints each of Bhaskar Panigrahi, Bala Padmakumar and Mahesh Choudhury of the Company and Shashi Khiani,
Caroline Steck and Nicholas Penn of Polsinelli PC as the undersigned’s true and lawful attorney-in-fact, with full power and authority
as hereinafter described on behalf of and in the name, place and stead of the undersigned to:
| 1. | Prepare, execute, acknowledge, deliver and file Forms 144, Schedules 13G or 13D, and Forms 3, 4, and 5
(including any amendments thereto), including applications for Form ID, and any actions or documents necessary to facilitate the
timely filing of notices of proposed sales and beneficial ownership reports, with respect to the securities of ConnectM Technology Solutions, Inc.,
a Delaware corporation (the “Company”), with the United States Securities and Exchange Commission, any national securities
exchanges and the Company, as considered necessary or advisable under Rule 144 promulgated under the Securities Act of 1933, as amended
from time to time (the “Securities Act”) and/or Sections 13(d) and 16(a) of the Securities Exchange Act of 1934
and the rules and regulations promulgated thereunder, as amended from time to time (the “Exchange Act”); |
| 2. | Seek or obtain, as the undersigned’s representative and on the undersigned’s behalf, information
on transactions in the Company’s securities from any third party, including brokers, employee benefit plan administrators and trustees,
and the undersigned hereby authorizes any such person to release any such information to the undersigned and approves and ratifies any
such release of information; and |
| 3. | Perform any and all other acts which in the discretion of the attorney-in-fact are necessary or desirable
for and on behalf of the undersigned in connection with the foregoing. |
The undersigned acknowledges that:
| 1. | This Limited Power of Attorney authorizes, but does not require, each attorney-in-fact to act in his or
her discretion on information provided to each such attorney-in-fact without independent verification of such information; |
| 2. | Any documents prepared and/or executed by an attorney-in-fact on behalf of the undersigned pursuant to
this Limited Power of Attorney will be in such form and will contain such information and disclosure as each such attorney-in-fact, in
his or her discretion, deems necessary or desirable; |
| 3. | None of the Company or any such attorney-in-fact assumes (i) any liability for the undersigned’s
responsibility to comply with the requirements of the Exchange Act, (ii) any liability of the undersigned for any failure to comply
with such requirements, or (iii) any obligation or liability of the undersigned for profit disgorgement under Section 13 or
16 of the Exchange Act; and |
| 4. | This Limited Power of Attorney does not relieve the undersigned from responsibility for compliance with
the undersigned’s obligations under the Securities Act or the Exchange Act, including without limitation the reporting requirements
under Rule 144 under the Securities Act or Sections 13(d) and 16 of the Exchange Act. The undersigned hereby gives and grants
each attorney-in-fact full power and authority to do and perform all and every act and thing whatsoever requisite, necessary or appropriate
to be done in and about the foregoing matters as fully to all intents and purposes as the undersigned might or could do if present, hereby
ratifying all that each such attorney-in-fact of, for and on behalf of the undersigned, shall lawfully do or cause to be done by virtue
of this Limited Power of Attorney. |
This Limited Power of Attorney shall remain in
full force and effect until revoked by the undersigned in a signed writing delivered to each attorney-in-fact.
IN WITNESS WHEREOF, the undersigned hereto has
caused this Limited Power of Attorney to be duly executed as of the day and year first above written.
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Monterrey Acquisition Sponsor, LLC |
|
|
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By: |
/s/
Bala Padmakumar |
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Name: |
Bala Padmakumar |
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Title: |
Managing Member |
Exhibit 24.1
LIMITED
POWER OF ATTORNEY
July 12, 2024
Know all by these presents, that the undersigned
hereby makes, constitutes and appoints each of Bhaskar Panigrahi and Mahesh Choudhury of the Company and Shashi Khiani, Caroline Steck
and Nicholas Penn of Polsinelli PC as the undersigned’s true and lawful attorney-in-fact, with full power and authority as hereinafter
described on behalf of and in the name, place and stead of the undersigned to:
| 1. | Prepare, execute, acknowledge, deliver and file Forms 144, Schedules 13G or 13D, and Forms 3, 4, and 5
(including any amendments thereto), including applications for Form ID, and any actions or documents necessary to facilitate the
timely filing of notices of proposed sales and beneficial ownership reports, with respect to the securities of ConnectM Technology Solutions, Inc.,
a Delaware corporation (the “Company”), with the United States Securities and Exchange Commission, any national securities
exchanges and the Company, as considered necessary or advisable under Rule 144 promulgated under the Securities Act of 1933, as amended
from time to time (the “Securities Act”) and/or Sections 13(d) and 16(a) of the Securities Exchange Act of 1934
and the rules and regulations promulgated thereunder, as amended from time to time (the “Exchange Act”); |
| 2. | Seek or obtain, as the undersigned’s representative and on the undersigned’s behalf, information
on transactions in the Company’s securities from any third party, including brokers, employee benefit plan administrators and trustees,
and the undersigned hereby authorizes any such person to release any such information to the undersigned and approves and ratifies any
such release of information; and |
| 3. | Perform any and all other acts which in the discretion of the attorney-in-fact are necessary or desirable
for and on behalf of the undersigned in connection with the foregoing. |
The undersigned acknowledges that:
| 1. | This Limited Power of Attorney authorizes, but does not require, each attorney-in-fact to act in his or
her discretion on information provided to each such attorney-in-fact without independent verification of such information; |
| 2. | Any documents prepared and/or executed by an attorney-in-fact on behalf of the undersigned pursuant to
this Limited Power of Attorney will be in such form and will contain such information and disclosure as each such attorney-in-fact, in
his or her discretion, deems necessary or desirable; |
| 3. | None of the Company or any such attorney-in-fact assumes (i) any liability for the undersigned’s
responsibility to comply with the requirements of the Exchange Act, (ii) any liability of the undersigned for any failure to comply
with such requirements, or (iii) any obligation or liability of the undersigned for profit disgorgement under Section 13 or
16 of the Exchange Act; and |
| 4. | This Limited Power of Attorney does not relieve the undersigned from responsibility for compliance with
the undersigned’s obligations under the Securities Act or the Exchange Act, including without limitation the reporting requirements
under Rule 144 under the Securities Act or Sections 13(d) and 16 of the Exchange Act. The undersigned hereby gives and grants
each attorney-in-fact full power and authority to do and perform all and every act and thing whatsoever requisite, necessary or appropriate
to be done in and about the foregoing matters as fully to all intents and purposes as the undersigned might or could do if present, hereby
ratifying all that each such attorney-in-fact of, for and on behalf of the undersigned, shall lawfully do or cause to be done by virtue
of this Limited Power of Attorney. |
This Limited Power of Attorney shall remain in
full force and effect until revoked by the undersigned in a signed writing delivered to each attorney-in-fact.
IN WITNESS WHEREOF, the undersigned hereto has
caused this Limited Power of Attorney to be duly executed as of the day and year first above written.
|
By: |
/s/ Bala Padmakumar |
|
Name: |
Bala Padmakumar |
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