Form 4 for MAX MediaAlpha, Inc.

Accepted 2021-09-03 00:00:00 ET · period of report 2021-09-01 · accession 0001818383-21-000096 · SEC index · Original document

Summary rows

Aggregated the way they appear in lists: one row per insider, transaction code and security table.

X	Filed	Traded	Ticker	Insider	Title	Type	Price	Qty	Owned	ΔOwn	Value
D	2021-09-03	2021-09-01	MAX	Perine Robert	VP, PRODUCT	M - OptEx	$0.00	+12.0K	32.2K	+59%	$0
D	2021-09-03	2021-09-01	MAX	Perine Robert	VP, PRODUCT	M - OptEx	$0.00	-12.0K	63.1K	-16%	$0

Purchase Sale Sale after option exercise All abbreviations

#	Table	Security	Date	Code	A/D	Shares	Price	Owned after	Own	Exercise / expiry	Underlying	Footnotes
1	Common	Class A Common Stock	2021-09-01	M	A	12,000	$0.00	32,211	D	—	—	(F1) On September 1, 2021, the Reporting Person exchanged 12,000 Class B-1 Units of QL Holdings LLC (the "Class B-1 Units"), along with 12,000 shares of Class B Common Stock (the "Class B Common Stock") for shares of Class A Common Stock on a one-for-one basis.
2	Derivative	Class B-1 Units of QL Holdings LLC and Class B Common Stock	2021-09-01	M	D	12,000	$0.00	63,119	D	— · — to —	12,000 Class A Common Stock	(F2) Pursuant to the Exchange Agreement, dated October 27, 2020, among the Issuer, QL Holdings LLC ("QLH"), Guilford Holdings, Inc. and the Class B-1 members of QLH, each Class B-1 Unit, together with one share of Class B Common Stock, is exchangeable for one share of Class A Common Stock, subject to vesting conditions set forth in separate agreements. (F1) On September 1, 2021, the Reporting Person exchanged 12,000 Class B-1 Units of QL Holdings LLC (the "Class B-1 Units"), along with 12,000 shares of Class B Common Stock (the "Class B Common Stock") for shares of Class A Common Stock on a one-for-one basis.