SEC FORM 3 SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
 
OMB APPROVAL
OMB Number: 3235-0104
Estimated average burden
hours per response: 0.5
1. Name and Address of Reporting Person*
Subramanian Anuradha B.

(Last) (First) (Middle)
C/O BUMBLE INC. 1105 WEST 41ST STREET

(Street)
AUSTIN TX 78756

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
02/11/2021
3. Issuer Name and Ticker or Trading Symbol
Bumble Inc. [ BMBL ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Chief Financial Officer
5. 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 Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Class B Common Stock 1 D
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Incentive Units of Buzz Holdings L.P. (1) 02/10/2028(1) Class A Common Stock(1) 599,422 13 D
Explanation of Responses:
1. Reflects Incentive Units of Buzz Holdings L.P. ("Incentive Units") which are profits interests that are economically similar to stock appreciation rights. Vested Incentive Units are convertible, at the holder's election, into common units of Buzz Holdings L.P. ("Common Units") pursuant to the terms thereof, which then shall be exchangeable for shares of Class A common stock of the Issuer on a one-for-one basis. These Incentive Units vest in five equal annual installments beginning on September 21, 2021. Any unexercised Incentive Units will automatically be converted into Common Units on February 10, 2028.
Remarks:
Exhibit List: Exhibit 24 - Power of Attorney.
/s/ Elizabeth Monteleone, Elizabeth Monteleone, Attorney-in-Fact 02/11/2021
** 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 5 (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.
                               POWER OF ATTORNEY

Know all by these presents that the undersigned, does hereby make, constitute
and appoint each of Laura Franco, Mariko O'Shea, Elizabeth Monteleone and Jiah
Ham, or any one of them, as a true and lawful attorney-in-fact of the
undersigned with full powers of substitution and revocation, for and in the
name, place and stead of the undersigned (in the undersigned's individual
capacity), to execute and deliver such forms that the undersigned may be
required to file with the U.S. Securities and Exchange Commission as a result of
the undersigned's ownership of or transactions in securities of Bumble Inc. (the
"Company") (i) pursuant to Section 16(a) of the Securities Exchange Act of 1934,
as amended, including without limitation, statements on Form 3, Form 4 and Form
5 (including any amendments thereto) and (ii) in connection with any
applications for EDGAR access codes or any other documents necessary or
appropriate to obtain codes and passwords enabling the undersigned to make
electronic filings with the Securities and Exchange Commission, including
without limitation the Form ID. The Power of Attorney shall remain in full force
and effect until the undersigned is no longer required to file Forms 3, 4 and 5
with regard to his or her ownership of or transactions in securities of the
Company, unless earlier revoked in writing. Laura Franco, Mariko O'Shea,
Elizabeth Monteleone and Jiah Ham are not assuming any of the undersigned's
responsibilities to comply with Section 16 of the Securities Exchange Act of
1934, as amended.

                                        By: /s/ Anuradha B. Subramanian
                                           ----------------------------
                                        Name: Anuradha B. Subramanian

                                        Date: January 14, 2021