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
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1. Name and Address of Reporting Person*
JCIC Sponsor LLC

(Last) (First) (Middle)
C/O JACK CREEK INVESTMENT CORP.,
386 PARK AVENUE SOUTH, FL 20

(Street)
NEW YORK NY 10016

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
01/21/2021
3. Issuer Name and Ticker or Trading Symbol
Jack Creek Investment Corp. [ JCIC ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director X 10% Owner
X Officer (give title below) Other (specify below)
See Remarks
5. 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 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)
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
Class B Ordinary Shares, par value $0.0001 (2) (2) Class A Ordinary Shares, par value $0.0001 8,575,000 (2) D(1)(3)(4)
1. Name and Address of Reporting Person*
JCIC Sponsor LLC

(Last) (First) (Middle)
C/O JACK CREEK INVESTMENT CORP.,
386 PARK AVENUE SOUTH, FL 20

(Street)
NEW YORK NY 10016

(City) (State) (Zip)
1. Name and Address of Reporting Person*
KSH Capital LP

(Last) (First) (Middle)
C/O JACK CREEK INVESTMENT CORP.,
386 PARK AVENUE SOUTH, FL 20

(Street)
NEW YORK NY 10016

(City) (State) (Zip)
1. Name and Address of Reporting Person*
KELTER JEFFREY E

(Last) (First) (Middle)
C/O JACK CREEK INVESTMENT CORP.,
386 PARK AVENUE SOUTH, FL 20

(Street)
NEW YORK NY 10016

(City) (State) (Zip)
1. Name and Address of Reporting Person*
SAVAGE ROBERT F JR

(Last) (First) (Middle)
C/O JACK CREEK INVESTMENT CORP.,
386 PARK AVENUE SOUTH, FL 20

(Street)
NEW YORK NY 10016

(City) (State) (Zip)
1. Name and Address of Reporting Person*
JERMOLUK THOMAS

(Last) (First) (Middle)
C/O JACK CREEK INVESTMENT CORP.,
386 PARK AVENUE SOUTH, FL 20

(Street)
NEW YORK NY 10016

(City) (State) (Zip)
Explanation of Responses:
1. This form is being filed by the following Reporting Rersons: JCIC Sponsor LLC (the "Sponsor"), KSH Capital LP ("KSH Capital"), Jeffrey E. Kelter, Robert F. Savage and Thomas Jermoluk. Because of the relationships among the Reporting Persons, the Reporting Persons may be deemed to beneficially own the securities reported herein to the extent of their respective pecuniary interests. Each Reporting Person disclaims beneficial ownership of the securities reported herein, except to the extent of such Reporting Person's pecuniary interest therein, if any.
2. The Sponsor owns 8,575,000 Class B ordinary shares, par value $0.0001 per share (the "Class B Ordinary Shares"), of Jack Creek Investment Corp. (the "Issuer"), including 1,125,000 Class B Ordinary Shares that are subject to forfeiture if the underwriter of the Issuer's initial public offering does not exercise in full an option granted to it to cover over-allotments. Class B Ordinary Shares have no expiration date and are convertible into Class A ordinary shares, par value $0.0001 per share, of the Issuer, as described under the heading "Description of Securities-founder shares" in the Issuer's registration statement on Form S-1 (File No. 333-248951).
3. The manager of the Sponsor is KSH Capital. Each of Jeffrey E. Kelter, Robert F. Savage and Thomas Jermoluk indirectly own an approximately 30% interest in Sponsor and, pursuant to the Sponsor's operating agreement, through their investment vehicles have a consent right over the Sponsor's investments, including voting and investment discretion with respect to the Class B Ordinary Shares held of record by the Sponsor.
4. Pursuant to Rule 16a-1(a)(4) under the Securities Exchange Act of 1934, as amended (the "Exchange Act"), this filing shall not be deemed an admission that the Reporting Persons are, for purposes of Section 16 of the Exchange Act or otherwise, the beneficial owners of any equity securities in excess of their respective pecuniary interests.
Remarks:
Exhibit 24.1 Power of Attorney Exhibit 99.1 Joint Filer Information (including signatures) is incorporated by reference herein.
See Exhibit 99.1 for Signatures 01/21/2021
** 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.
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