SEC FORM 4 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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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
CHW Acquisition Sponsor LLC

(Last) (First) (Middle)
C/O CHW ACQUISITION CORPORATION,
2 MANHATTANVILLE ROAD SUITE 403

(Street)
PURCHASE NY 10577

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
CHW Acquisition Corp [ CHWA ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director X 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
10/01/2021
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Ordinary Shares, par value $0.0001 10/01/2021 J(1)(2) 30,000 A $0 2,405,000 D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Explanation of Responses:
1. As described in CHW Acquisition Corporation's (the "Issuer") registration statements on Form S-1 (File Nos. 333-254422 and 333-259182), as amended and (the "Registration Statement"), 13 qualified institutional buyers or institutional accredited investors (each, an "Anchor Investor") entered into investment agreements with the Issuer and CHW Acquisition Sponsor LLC, a Delaware limited liability company (the "Sponsor"), whereby each Anchor Investor agreed to purchase up to 990,000 units in the Issuer's initial public offering of its securities (the "IPO") in exchange for the Sponsor transferring 60,000 ordinary shares, par value $0.0001 per share (the "Founder Shares")
2. to each Anchor Investor; provided, however, in the event that an Anchor Investor sold any of the securities purchased in the IPO within 30 days following the closing of the IPO, such Anchor Investor would forfeit 10,000 Founder Shares and transfer those forfeited Founder Shares back to the Sponsor. Three Anchor Investors sold either a portion or all of the securities purchased in the Issuer's IPO within 30 days following the closing of the IPO. Thus, each of those Anchor Investors forfeited 10,000 Founder Shares and transferred them back to the Sponsor.
CHW Acquisition Sponsor LLC By: CHW Founders LLC, Sole Managing Member By: MJG Partners, Sole Managing Member By: Mark Grundman, Manager 10/05/2021
** 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).
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