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
 
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1. Name and Address of Reporting Person*
Furman Donald Steven

(Last) (First) (Middle)
1100 W. TOWN & COUNTRY RD.
SUITE 1600

(Street)
ORANGE CA 92868

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
08/15/2023
3. Issuer Name and Ticker or Trading Symbol
Alignment Healthcare, Inc. [ ALHC ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Chief Clinical 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)
Common Stock 1,533,399(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
Options (Right to Buy) (2) 03/25/2031 Common Stock 115,954 18 D
Explanation of Responses:
1. Represents (i) 1,513,024 shares of common stock of Alignment Healthcare, Inc. (the "Company") and (ii) 20,375 shares of restricted stock which become vested on 8/1/24, subject to Dr. Furman's continued service to the Company on the vesting date.
2. Options are fully vested.
Remarks:
Substitute Power of Attorney - Exh. 24
/s/ Christopher J. Joyce, as Attorney-in-Fact, for Donald S. Furman 08/22/2023
** 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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SUBSTITUTE POWER OF ATTORNEY

Under the terms of the powers of attorney listed on Exhibit A attached hereto
(the "Powers of Attorney") the undersigned, Richard A. Cross, was appointed
attorney-in-fact for the individuals named in the Powers of Attorney (the
"Section 16 Filers"), to, among other things, execute for and on behalf of the
Section 16 Filers any required Form 3, 4 and 5 in accordance with Section 16(a)
of the Securities Exchange Act of 1934, as amended, and the rules thereunder.
In accordance with the authority granted under the Powers of Attorney, including
the power of substitution, the undersigned hereby appoints Christopher J. Joyce
as substitute attorney-in-fact, on behalf of each of the Section 16 Filers, with
the power to act without any other and with full power of substitution, to
exercise and execute all of the powers granted or conferred in the original
Powers of Attorney.  By his signature as attorney-in-fact to this Substitute
Power of Attorney, Christopher J. Joyce accepts such appointment and agrees to
assume from the undersigned any and all duties and responsibilities attendant to
his capacity as attorney-in-fact.

Date: August 22, 2023

By: /s/ Richard A. Cross
Richard A. Cross
Attorney-in-Fact

I ACCEPT THIS APPOINTMENT
AND SUBSTITUTION:

/s/ Christopher J. Joyce
Christopher J. Joyce

Exhibit A

Power of Attorney of Donald S. Furman dated November 23, 2021