# EDGAR Filing Document

**Accession Number:** 0001647639
**File Stem:** 0001628280-23-008787
**Filing Date:** 2023-3
**Character Count:** 7913
**Document Hash:** 7c1b14deb312557492be58ea634d05d0
**Contains OCR:** False
**Source Format:** 

## Filing Content

## Filing Summary
**0001628280-23-008787.hdr.sgml**: 20230321

**ACCESSION NUMBER**: 0001628280-23-008787

**CONFORMED SUBMISSION TYPE**: 4

**PUBLIC DOCUMENT COUNT**: 1

**CONFORMED PERIOD OF REPORT**: 20230317

**FILED AS OF DATE**: 20230321

**DATE AS OF CHANGE**: 20230321

**REPORTING-OWNER**: 

**OWNER DATA:**
- **COMPANY CONFORMED NAME:** Girouard Dave
- **CENTRAL INDEX KEY:** 0001832805

**FILING VALUES:**
- **FORM TYPE:** 4
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 001-39797
- **FILM NUMBER:** 23750714

**MAIL ADDRESS:**
- **STREET 1:** C/O UPSTART HOLDINGS, INC.
- **STREET 2:** 2950 S. DELAWARE STREET, SUITE 300
- **CITY:** SAN MATEO
- **STATE:** CA
- **ZIP:** 94403
**ISSUER**: 

**COMPANY DATA:**
- **COMPANY CONFORMED NAME:** Upstart Holdings, Inc.
- **CENTRAL INDEX KEY:** 0001647639
- **STANDARD INDUSTRIAL CLASSIFICATION:** FINANCE SERVICES [6199]
- **IRS NUMBER:** 464332431
- **STATE OF INCORPORATION:** DE
- **FISCAL YEAR END:** 1231

**BUSINESS ADDRESS:**
- **STREET 1:** 2950 S. DELAWARE STREET, SUITE 300
- **CITY:** SAN MATEO
- **STATE:** CA
- **ZIP:** 94403
- **BUSINESS PHONE:** (650) 204-1000

**MAIL ADDRESS:**
- **STREET 1:** 2950 S. DELAWARE STREET, SUITE 300
- **CITY:** SAN MATEO
- **STATE:** CA
- **ZIP:** 94403

### UNITED STATES SECURITIES AND EXCHANGE COMMISSION
**Washington, D.C. 20549**

## FORM 4

### STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

[ ] 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**<sup>*</sup><br>Girouard Dave<br><sub>(Last) (First) (Middle)</sub><br>C/O UPSTART HOLDINGS, INC.<br>2950 S. DELAWARE STREET, SUITE 300<br><sub>(Street)</sub><br>SAN MATEO, CA 94403<br><sub>(City) (State) (Zip)</sub> | **3. Date of Earliest Transaction (Month/Day/Year)**<br>2023-03-17 | **5. Relationship of Reporting Person(s) to Issuer**<br>(Check all applicable)<br>[X] Director [X] 10% Owner<br>[X] Officer (give title below) [ ] Other (specify below)<br>_Chief Executive Officer_ |
| **2. Issuer Name and Ticker or Trading Symbol**<br>Upstart Holdings, Inc. [ UPST ] | **4. If Amendment, Date of Original Filed (Month/Day/Year)**<br>  | **6. Individual or Joint/Group Filing (Check Applicable Line)**<br>[X] Form filed by One Reporting Person<br>[ ] Form filed by More than One Reporting Person |

---

## Table I - Non-Derivative Securities

---

|  |  |  |  |  |  |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| 1. Title of Security | 2. Transaction Date | 2A. Deemed Execution Date | 3. Transaction Code (V) | 3. Transaction Code (V) | 4. Securities Acquired (A) or Disposed of (D) | 4. Securities Acquired (A) or Disposed of (D) | 4. Securities Acquired (A) or Disposed of (D) | 5. Amount of Securities Beneficially Owned | 6. Ownership Form | 7. Nature of Indirect Beneficial Ownership |
| 1. Title of Security | 2. Transaction Date | 2A. Deemed Execution Date | Code | V | Amount | (A) or (D) | Price | 5. Amount of Securities Beneficially Owned | 6. Ownership Form | 7. Nature of Indirect Beneficial Ownership |
| Common Stock |  |  |  |  |  |  |  | 126057<sup>(1)</sup> | I | See Footnote<sup>(2)</sup> |
| Common Stock |  |  |  |  |  |  |  | 126057<sup>(3)</sup> | I | See Footnote<sup>(4)</sup> |
| Common Stock |  |  |  |  |  |  |  | 0<sup>(5)</sup> | I | See Footnote<sup>(6)</sup> |
| Common Stock |  |  |  |  |  |  |  | 83066 | D |  |
| Common Stock |  |  |  |  |  |  |  | 8342701 | I | See Footnote<sup>(7)</sup> |
| Common Stock |  |  |  |  |  |  |  | 1000000 | I | See Footnote<sup>(8)</sup> |
| Common Stock |  |  |  |  |  |  |  | 546501 | I | See Footnote<sup>(9)</sup> |
| Common Stock |  |  |  |  |  |  |  | 546501 | I | See Footnote<sup>(10)</sup> |

---

## Table II - Derivative Securities

---

|  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| 1. Title of Derivative Security | 2. Conversion or Exercise Price | 3. Transaction Date | 3A. Deemed Execution Date | 4. Transaction Code (V) | 4. Transaction Code (V) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) | 6. Date Exercisable and Expiration Date | 6. Date Exercisable and Expiration Date | 7. Title and Amount of Underlying Securities | 7. Title and Amount of Underlying Securities | 8. Price of Derivative Security | 9. Number of Derivative Securities Beneficially Owned | 10. Ownership Form | 11. Nature of Indirect Beneficial Ownership |
| 1. Title of Derivative Security | 2. Conversion or Exercise Price | 3. Transaction Date | 3A. Deemed Execution Date | Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | 8. Price of Derivative Security | 9. Number of Derivative Securities Beneficially Owned | 10. Ownership Form | 11. Nature of Indirect Beneficial Ownership |
| Employee Stock Option (Right to buy) | $15.23 | 2023-03-17 |  | A |  | 806704 |  | <sup>(11)</sup> | 2033-03-17 | Common Stock | 806704.0 | $0 | 806704 | D |  |

---

### Footnotes:

(1) The number of shares held reflects the transfer, on March 2, 2023, of 126,057 shares of common stock from David J. Girouard, as trustee of the Girouard 2020 GRAT dated October 19, 2020 (the "2020 GRAT") to the TMG 2020 NONEXEMPT GIFT TRUST, dated October 19, 2020, for which Tristan Baird serves as trustee(the"TMG Nonexempt Gift Trust".

(2) These shares are held the TMG Nonexempt Gift Trust.

(3) The number of shares held reflects the transfer, on March 2, 2023, of 126,057 shares of common stock from the 2020 GRAT to the JRG 2020 NONEXEMPT GIFT TRUST, dated October 19, 2020, for which Tristan Baird serves as trustee (the JRG Nonexempt Gift Trust").

(4) These shares are held by the JRG NONEXEMPT GIFT TRUST.

(5) The number of shares held reflects the transfer, on March 2, 2023, an aggregate of 252,114 shares of Common Stock from the "2020 GRAT", 126,057 shares to the TMG Nonexempt Gift Trust and 126,057 shares to the JRG Nonexempt Gift Trust.

(6) These shares are held by the 2020 GRAT.

(7) These shares are held by 2008 D&T Girouard Revocable Trust, for which the Reporting Person serves as Trustee.

(8) These shares are held by David J Girouard, as trustee of the DTG GRAT LLC, dated May 23,2023.

(9) These shares are held by Tristen Baird Willard, as trustee of the TMG 2020 EXEMPT GIFT TRUST, dated October 19, 2020.

(10) These shares are held by Tristen Baird Willard, as trustee of the JRG 2020 EXEMPT GIFT TRUST, dated October 19, 2020.

(11) 1/48th of the shares subject to the option shall vest on March 20, 2023 and each successive one-month period thereafter, subject to the Reporting Person continuing as a service provider through each such date.

**Signature:** /s/ Christopher Ing, by power of attorney  
**Date:** 2023-03-21

### Remarks:

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.**