SEC FORM 4

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

OMB APPROVAL

OMB Number:			3235-0287
Estimated average burden
hours per response:			0.5

Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).

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^*

SC US (TTGP), LTD.

(Last)

(First)

(Middle)

2800 SAND HILL ROAD SUITE 101

(Street)

MENLO PARK

94025

(City)

(State)

(Zip)

2. Issuer Name and Ticker or Trading Symbol
Ethos Technologies Inc. [ LIFE ]

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)
01/30/2026

4. If Amendment, Date of Original Filed (Month/Day/Year)

6. Individual or Joint/Group Filing (Check Applicable Line)

	Form filed by One Reporting Person
X	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)
1. Title of Security (Instr. 3)	2. Transaction Date (Month/Day/Year)	2A. Deemed Execution Date, if any (Month/Day/Year)	Code	V	Amount	(A) or (D)	Price		6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)	7. Nature of Indirect Beneficial Ownership (Instr. 4)
Class A Common Stock	01/30/2026		C⁽¹⁾		8,027,281	A	$0	8,027,281	I	Sequoia Capital U.S. Venture Fund XV, L.P.⁽²⁾⁽³⁾
Class A Common Stock	01/30/2026		C⁽¹⁾		337,996	A	$0	337,996	I	Sequoia Capital U.S. Venture Partners Fund XV (Q), L.P.⁽²⁾⁽³⁾
Class A Common Stock	01/30/2026		C⁽¹⁾		121,541	A	$0	121,541	I	Sequoia Capital U.S. Venture Partners Fund XV, L.P.⁽²⁾⁽³⁾
Class A Common Stock	01/30/2026		C⁽¹⁾		1,238,282	A	$0	1,238,282	I	Sequoia Capital U.S. Venture XV Principals Fund, L.P.⁽²⁾⁽³⁾
Class A Common Stock	01/30/2026		C⁽¹⁾		2,132,408	A	$0	2,132,408	I	Sequoia Capital U.S. Growth Fund VIII, L.P.⁽²⁾⁽³⁾
Class A Common Stock	01/30/2026		C⁽¹⁾		142,616	A	$0	142,616	I	See Footnotes⁽⁴⁾⁽⁵⁾⁽⁶⁾
Class A Common Stock	01/30/2026		D⁽¹⁾		8,027,281	D	$0	0	I	Sequoia Capital U.S. Venture Fund XV, L.P.⁽²⁾⁽³⁾
Class A Common Stock	01/30/2026		D⁽¹⁾		337,996	D	$0	0	I	Sequoia Capital U.S. Venture Partners Fund XV (Q), L.P.⁽²⁾⁽³⁾
Class A Common Stock	01/30/2026		D⁽¹⁾		121,541	D	$0	0	I	Sequoia Capital U.S. Venture Partners Fund XV, L.P.⁽²⁾⁽³⁾
Class A Common Stock	01/30/2026		D⁽¹⁾		1,238,282	D	$0	0	I	Sequoia Capital U.S. Venture XV Principals Fund, L.P.⁽²⁾⁽³⁾
Class A Common Stock	01/30/2026		D⁽¹⁾		2,132,408	D	$0	0	I	Sequoia Capital U.S. Growth Fund VIII, L.P.⁽²⁾⁽³⁾
Class A Common Stock	01/30/2026		D⁽¹⁾		142,616	D	$0	0	I	See Footnotes⁽⁴⁾⁽⁵⁾⁽⁶⁾

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)
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)	Code	V	(A)	(D)	Date Exercisable	Expiration Date	Title	Amount or Number of Shares	8. Price of Derivative Security (Instr. 5)		10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)	11. Nature of Indirect Beneficial Ownership (Instr. 4)
Series A-2 Preferred Stock	⁽¹⁾	01/30/2026		C⁽¹⁾			1,897,656	⁽¹⁾	⁽¹⁾	Class A Common Stock	1,897,656	$0	0	I	Sequoia Capital U.S. Venture Fund XV, L.P.⁽²⁾⁽³⁾
Series A-2 Preferred Stock	⁽¹⁾	01/30/2026		C⁽¹⁾			79,975	⁽¹⁾	⁽¹⁾	Class A Common Stock	79,975	$0	0	I	Sequoia Capital U.S. Venture Partners Fund XV (Q), L.P.⁽²⁾⁽³⁾
Series A-2 Preferred Stock	⁽¹⁾	01/30/2026		C⁽¹⁾			28,725	⁽¹⁾	⁽¹⁾	Class A Common Stock	28,725	$0	0	I	Sequoia Capital U.S. Venture Partners Fund XV, L.P.⁽²⁾⁽³⁾
Series A-2 Preferred Stock	⁽¹⁾	01/30/2026		C⁽¹⁾			291,875	⁽¹⁾	⁽¹⁾	Class A Common Stock	291,875	$0	0	I	Sequoia Capital U.S. Venture XV Principals Fund, L.P.⁽²⁾⁽³⁾
Series A-2 Preferred Stock	⁽¹⁾	01/30/2026		C⁽¹⁾			142,616	⁽¹⁾	⁽¹⁾	Class A Common Stock	142,616	$0	0	I	See Footnotes⁽⁴⁾⁽⁵⁾⁽⁶⁾
Series A Preferred Stock	⁽¹⁾	01/30/2026		C⁽¹⁾			4,767,653	⁽¹⁾	⁽¹⁾	Class A Common Stock	4,767,653	$0	0	I	Sequoia Capital U.S. Venture Fund XV, L.P.⁽²⁾⁽³⁾
Series A Preferred Stock	⁽¹⁾	01/30/2026		C⁽¹⁾			200,936	⁽¹⁾	⁽¹⁾	Class A Common Stock	200,936	$0	0	I	Sequoia Capital U.S. Venture Partners Fund XV (Q), L.P.⁽²⁾⁽³⁾
Series A Preferred Stock	⁽¹⁾	01/30/2026		C⁽¹⁾			72,174	⁽¹⁾	⁽¹⁾	Class A Common Stock	72,174	$0	0	I	Sequoia Capital U.S. Venture Partners Fund XV, L.P.⁽²⁾⁽³⁾
Series A Preferred Stock	⁽¹⁾	01/30/2026		C⁽¹⁾			733,307	⁽¹⁾	⁽¹⁾	Class A Common Stock	733,307	$0	0	I	Sequoia Capital U.S. Venture XV Principals Fund, L.P.⁽²⁾⁽³⁾
Series B Preferred Stock	⁽¹⁾	01/30/2026		C⁽¹⁾			1,124,709	⁽¹⁾	⁽¹⁾	Class A Common Stock	1,124,709	$0	0	I	Sequoia Capital U.S. Venture Fund XV, L.P.⁽²⁾⁽³⁾
Series B Preferred Stock	⁽¹⁾	01/30/2026		C⁽¹⁾			47,400	⁽¹⁾	⁽¹⁾	Class A Common Stock	47,400	$0	0	I	Sequoia Capital U.S. Venture Partners Fund XV (Q), L.P.⁽²⁾⁽³⁾
Series B Preferred Stock	⁽¹⁾	01/30/2026		C⁽¹⁾			17,025	⁽¹⁾	⁽¹⁾	Class A Common Stock	17,025	$0	0	I	Sequoia Capital U.S. Venture Partners Fund XV, L.P.⁽²⁾⁽³⁾
Series B Preferred Stock	⁽¹⁾	01/30/2026		C⁽¹⁾			172,989	⁽¹⁾	⁽¹⁾	Class A Common Stock	172,989	$0	0	I	Sequoia Capital U.S. Venture XV Principals Fund, L.P.⁽²⁾⁽³⁾
Series C Preferred Stock	⁽¹⁾	01/30/2026		C⁽¹⁾			180,988	⁽¹⁾	⁽¹⁾	Class A Common Stock	180,988	$0	0	I	Sequoia Capital U.S. Venture Fund XV, L.P.⁽²⁾⁽³⁾
Series C Preferred Stock	⁽¹⁾	01/30/2026		C⁽¹⁾			7,627	⁽¹⁾	⁽¹⁾	Class A Common Stock	7,627	$0	0	I	Sequoia Capital U.S. Venture Partners Fund XV (Q), L.P.⁽²⁾⁽³⁾
Series C Preferred Stock	⁽¹⁾	01/30/2026		C⁽¹⁾			2,739	⁽¹⁾	⁽¹⁾	Class A Common Stock	2,739	$0	0	I	Sequoia Capital U.S. Venture Partners Fund XV, L.P.⁽²⁾⁽³⁾
Series C Preferred Stock	⁽¹⁾	01/30/2026		C⁽¹⁾			27,837	⁽¹⁾	⁽¹⁾	Class A Common Stock	27,837	$0	0	I	Sequoia Capital U.S. Venture XV Principals Fund, L.P.⁽²⁾⁽³⁾
Series C Preferred Stock	⁽¹⁾	01/30/2026		C⁽¹⁾			1,917,944	⁽¹⁾	⁽¹⁾	Class A Common Stock	1,917,944	$0	0	I	Sequoia Capital U.S. Growth Fund VIII, L.P.⁽²⁾⁽³⁾
Series D Preferred Stock	⁽¹⁾	01/30/2026		C⁽¹⁾			56,275	⁽¹⁾	⁽¹⁾	Class A Common Stock	56,275	$0	0	I	Sequoia Capital U.S. Venture Fund XV, L.P.⁽²⁾⁽³⁾
Series D Preferred Stock	⁽¹⁾	01/30/2026		C⁽¹⁾			2,058	⁽¹⁾	⁽¹⁾	Class A Common Stock	2,058	$0	0	I	Sequoia Capital U.S. Venture Partners Fund XV (Q), L.P.⁽²⁾⁽³⁾
Series D Preferred Stock	⁽¹⁾	01/30/2026		C⁽¹⁾			878	⁽¹⁾	⁽¹⁾	Class A Common Stock	878	$0	0	I	Sequoia Capital U.S. Venture Partners Fund XV, L.P.⁽²⁾⁽³⁾
Series D Preferred Stock	⁽¹⁾	01/30/2026		C⁽¹⁾			12,274	⁽¹⁾	⁽¹⁾	Class A Common Stock	12,274	$0	0	I	Sequoia Capital U.S. Venture XV Principals Fund, L.P.⁽²⁾⁽³⁾
Series D Preferred Stock	⁽¹⁾	01/30/2026		C⁽¹⁾			214,464	⁽¹⁾	⁽¹⁾	Class A Common Stock	214,464	$0	0	I	Sequoia Capital U.S. Growth Fund VIII, L.P.⁽²⁾⁽³⁾
Class B Common Stock	⁽¹⁾	01/30/2026		A⁽¹⁾		8,027,281		⁽¹⁾	⁽¹⁾	Class A Common Stock	8,027,281	$0	8,027,281	I	Sequoia Capital U.S. Venture Fund XV, L.P.⁽²⁾⁽³⁾
Class B Common Stock	⁽¹⁾	01/30/2026		A⁽¹⁾		337,996		⁽¹⁾	⁽¹⁾	Class A Common Stock	337,996	$0	337,996	I	Sequoia Capital U.S. Venture Partners Fund XV (Q), L.P.⁽²⁾⁽³⁾
Class B Common Stock	⁽¹⁾	01/30/2026		A⁽¹⁾		121,541		⁽¹⁾	⁽¹⁾	Class A Common Stock	121,541	$0	121,541	I	Sequoia Capital U.S. Venture Partners Fund XV, L.P.⁽²⁾⁽³⁾
Class B Common Stock	⁽¹⁾	01/30/2026		A⁽¹⁾		1,238,282		⁽¹⁾	⁽¹⁾	Class A Common Stock	1,238,282	$0	1,238,282	I	Sequoia Capital U.S. Venture XV Principals Fund, L.P.⁽²⁾⁽³⁾
Class B Common Stock	⁽¹⁾	01/30/2026		A⁽¹⁾		2,132,408		⁽¹⁾	⁽¹⁾	Class A Common Stock	2,132,408	$0	2,132,408	I	Sequoia Capital U.S. Growth Fund VIII, L.P.⁽²⁾⁽³⁾
Class B Common Stock	⁽¹⁾	01/30/2026		A⁽¹⁾		142,616		⁽¹⁾	⁽¹⁾	Class A Common Stock	142,616	$0	142,616	I	See Footnotes⁽⁴⁾⁽⁵⁾⁽⁷⁾

1. Name and Address of Reporting Person^*

SC US (TTGP), LTD.

(Last)

(First)

(Middle)

2800 SAND HILL ROAD SUITE 101

(Street)

MENLO PARK

94025

(City)

(State)

(Zip)

Relationship of Reporting Person(s) to Issuer

Director	X	10% Owner
Officer (give title below)		Other (specify below)

1. Name and Address of Reporting Person^*

SC U.S. Venture XV Management, L.P.

(Last)

(First)

(Middle)

2800 SAND HILL ROAD SUITE 101

(Street)

MENLO PARK

94025

(City)

(State)

(Zip)

Relationship of Reporting Person(s) to Issuer

Director	X	10% Owner
Officer (give title below)		Other (specify below)

1. Name and Address of Reporting Person^*

SEQUOIA CAPITAL U.S. VENTURE FUND XV, L.P.

(Last)

(First)

(Middle)

2800 SAND HILL ROAD SUITE 101

(Street)

MENLO PARK

94025

(City)

(State)

(Zip)

Relationship of Reporting Person(s) to Issuer

Director	X	10% Owner
Officer (give title below)		Other (specify below)

1. Name and Address of Reporting Person^*

SEQUOIA CAPITAL U.S. VENTURE PARTNERS FUND XV (Q), L.P.

(Last)

(First)

(Middle)

2800 SAND HILL ROAD SUITE 101

(Street)

MENLO PARK

94025

(City)

(State)

(Zip)

Relationship of Reporting Person(s) to Issuer

Director	X	10% Owner
Officer (give title below)		Other (specify below)

1. Name and Address of Reporting Person^*

SEQUOIA CAPITAL U.S. VENTURE PARTNERS FUND XV, L.P.

(Last)

(First)

(Middle)

2800 SAND HILL ROAD SUITE 101

(Street)

MENLO PARK

94025

(City)

(State)

(Zip)

Relationship of Reporting Person(s) to Issuer

Director	X	10% Owner
Officer (give title below)		Other (specify below)

1. Name and Address of Reporting Person^*

SEQUOIA CAPITAL U.S. VENTURE XV PRINCIPALS FUND, L.P.

(Last)

(First)

(Middle)

2800 SAND HILL ROAD SUITE 101

(Street)

MENLO PARK

94025

(City)

(State)

(Zip)

Relationship of Reporting Person(s) to Issuer

Director	X	10% Owner
Officer (give title below)		Other (specify below)

1. Name and Address of Reporting Person^*

SC U.S. Growth VIII Management, L.P.

(Last)

(First)

(Middle)

2800 SAND HILL ROAD SUITE 101

(Street)

MENLO PARK

94025

(City)

(State)

(Zip)

Relationship of Reporting Person(s) to Issuer

Director	X	10% Owner
Officer (give title below)		Other (specify below)

1. Name and Address of Reporting Person^*

Sequoia Capital U.S. Growth Fund VIII, L.P.

(Last)

(First)

(Middle)

2800 SAND HILL ROAD SUITE 101

(Street)

MENLO PARK

94025

(City)

(State)

(Zip)

Relationship of Reporting Person(s) to Issuer

Director	X	10% Owner
Officer (give title below)		Other (specify below)

1. Name and Address of Reporting Person^*

SC US SSF 2013 (TTGP), L.L.C.

(Last)

(First)

(Middle)

2800 SAND HILL ROAD SUITE 101

(Street)

MENLO PARK

94025

(City)

(State)

(Zip)

Relationship of Reporting Person(s) to Issuer

Director	X	10% Owner
Officer (give title below)		Other (specify below)

1. Name and Address of Reporting Person^*

SC U.S. SCOUT SEED FUND 2013 MANAGEMENT, L.P.

(Last)

(First)

(Middle)

2800 SAND HILL ROAD SUITE 101

(Street)

MENLO PARK

94025

(City)

(State)

(Zip)

Relationship of Reporting Person(s) to Issuer

Director	X	10% Owner
Officer (give title below)		Other (specify below)

Explanation of Responses:

1. Upon the closing of the Issuer's IPO, all shares of Series A-2, Series A, Series B, Series C, and Series D Preferred Stock automatically converted into shares of Class A Common Stock of the Issuer (the "Class A Conversion") based on the IPO price of the Class A Common Stock. Immediately following the Class A Conversion, shares of the Class A Common Stock included in this Form 4 exchanged at a 1:1 ratio for shares of Class B Common Stock. Each share of Class B Common Stock is convertible at the option of the holder thereof into one share of Class A Common Stock and otherwise in accordance with the terms of the Issuer's Certificate of Incorporation. The securities have no expiration date.

2. SC US (TTGP), Ltd. is (i) the general partner of SC U.S. Growth VIII Management, L.P., which is the general partner of Sequoia Capital U.S. Growth Fund VIII, L.P. (GFVIII), and (ii) the general partner of SC U.S. Venture XV Management, L.P., which is the general partner of Sequoia Capital U.S. Venture Fund XV, L.P., Sequoia Capital U.S. Venture Partners Fund XV (Q), L.P., Sequoia Capital U.S. Venture Partners Fund XV, L.P., and Sequoia Capital U.S. Venture XV Principals Fund, L.P. (collectively, the XV Funds).

3. [continued from Footnote 2] As a result, SC US (TTGP), Ltd. may be deemed to share voting and dispositive power with respect to the shares held by GFVIII and the XV Funds. Each of SC US (TTGP), Ltd., SC U.S. Growth VIII Management, L.P. and SC U.S. Venture XV Management, L.P. disclaims beneficial ownership of the shares held by GFVIII and the XV Funds, as applicable, except to the extent of its pecuniary interest therein, and the inclusion of these securities in this report shall not be deemed an admission of beneficial ownership of the reported securities for purposes of Section 16 or for any other purposes.

4. SC US SSF 2013 (TTGP), L.L.C. is the general partner of SC U.S. Scout Seed Fund 2013 Management, L.P., which is the general partner of Sequoia Capital U.S. Scout Seed Fund 2013, L.P., which wholly owns Sequoia Capital U.S. Scout Fund IV, L.L.C., which in turn wholly owns Nalrena, L.L.C. and Spelunker Channel Holdings, LLC (collectively, the Scout Funds). As a result, SC US SSF 2013 (TTGP), L.L.C., SC U.S. Scout Seed Fund 2013 Management, L.P., Sequoia Capital U.S. Scout Seed Fund 2013, L.P., and Sequoia Capital U.S. Scout Fund IV, L.L.C. may be deemed to share voting and dispositive power with respect to the shares held by the Scout Funds.

5. [continued from Footnote 4] Each of SC US SSF 2013 (TTGP), L.L.C., SC U.S. Scout Seed Fund 2013 Management, L.P., Sequoia Capital U.S. Scout Seed Fund 2013, L.P., and Sequoia Capital U.S. Scout Fund IV, L.L.C. disclaims beneficial ownership of the securities held by the Scout Funds except to the extent of its pecuniary interest therein, and the inclusion of these securities in this report shall not be deemed an admission of beneficial ownership of the reported securities for purposes of Section 16 or for any other purposes.

6. Includes 79,246 shares of Class A Common Stock held by Spelunker Channel Holdings, LLC and 63,370 shares of Class A Common Stock held by Nalrena LLC.

7. Includes 79,246 shares of Class B Common Stock held by Spelunker Channel Holdings, LLC and 63,370 shares of Class B Common Stock held by Nalrena LLC.

Remarks:

1 of 2

	/s/ Jung Yeon Son, by power of attorney for Roelof Botha, a Director of SC US (TTGP), Ltd.	02/02/2026
	/s/ Jung Yeon Son, by power of attorney for Roelof Botha, a Director of SC US (TTGP), Ltd., the General Partner of SC U.S. Venture XV Management, L.P.	02/02/2026
	/s/ Jung Yeon Son, by power of attorney for Roelof Botha, a Director of SC US (TTGP), Ltd., the General Partner of SC U.S. Venture XV Management, L.P., the General Partner of Sequoia Capital U.S. Venture Fund XV, L.P	02/02/2026
	/s/ Jung Yeon Son, by power of attorney for Roelof Botha, a Director of SC US (TTGP), Ltd., the General Partner of SC U.S. Venture XV Management, L.P., the General Partner of Sequoia Capital U.S. Venture Partners Fund XV (Q), L.P.	02/02/2026
	/s/ Jung Yeon Son, by power of attorney for Roelof Botha, a Director of SC US (TTGP), Ltd., the General Partner of SC U.S. Venture XV Management, L.P., the General Partner of Sequoia Capital U.S. Venture Partners Fund XV, L.P.	02/02/2026
	/s/ Jung Yeon Son, by power of attorney for Roelof Botha, a Director of SC US (TTGP), Ltd., the General Partner of SC U.S. Venture XV Management, L.P., the General Partner of Sequoia Capital U.S. Venture XV Principals Fund, L.P.	02/02/2026
	/s/ Jung Yeon Son, by power of attorney for Roelof Botha, a Director of SC US (TTGP), Ltd., the General Partner of SC U.S. Growth VIII Management, L.P.	02/02/2026
	/s/ Jung Yeon Son, by power of attorney for Roelof Botha, a Director of SC US (TTGP), Ltd., the General Partner of SC U.S. Growth VIII Management, L.P., the General Partner of Sequoia Capital U.S. Growth Fund VIII, L.P.	02/02/2026
	/s/ Jung Yeon Son, by power of attorney for Roelof Botha, a Director of SC US SSF 2013 (TTGP), L.L.C.	02/02/2026
	/s/ Jung Yeon Son, by power of attorney for Roelof Botha, a Director of SC US SSF 2013 (TTGP), L.L.C., the General Partner of SC U.S. Scout Seed Fund 2013 Management, L.P.	02/02/2026
	** 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.

Large owner Sc Us (Ttgp), Ltd. converted options into 12,000,124 shares and returned 12,000,124 shares to the company (SEC Form 4)