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*
SCS Sponsor III LLC

(Last) (First) (Middle)
SOCIAL CAPITAL SUVRETTA HLDNGS CORP III
2850 W HORIZON RIDGE PARKWAY, STE 200

(Street)
HENDERSON NV 89052

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
06/29/2021
3. Issuer Name and Ticker or Trading Symbol
Social Capital Suvretta Holdings Corp. III [ DNAC ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director X 10% Owner
Officer (give title below) Other (specify below)
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 (1) (1) Class A ordinary shares 6,295,000 (1) D(2)
1. Name and Address of Reporting Person*
SCS Sponsor III LLC

(Last) (First) (Middle)
SOCIAL CAPITAL SUVRETTA HLDNGS CORP III
2850 W HORIZON RIDGE PARKWAY, STE 200

(Street)
HENDERSON NV 89052

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Palihapitiya Chamath

(Last) (First) (Middle)
SOCIAL CAPITAL SUVRETTA HLDNGS CORP III
2850 W HORIZON RIDGE PARKWAY, STE 200

(Street)
HENDERSON NV 89052

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Mehta Kishan

(Last) (First) (Middle)
540 MADISON AVENUE, 7TH FLOOR

(Street)
NEW YORK NY 10022

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Cowen Aaron

(Last) (First) (Middle)
540 MADISON AVENUE, 7TH FLOOR

(Street)
NEW YORK NY 10022

(City) (State) (Zip)
1. Name and Address of Reporting Person*
ChaChaCha DNA III, LLC

(Last) (First) (Middle)
SOCIAL CAPITAL SUVRETTA HLDNGS CORP III
2850 W HORIZON RIDGE PARKWAY, STE 200

(Street)
HENDERSON NV 89052

(City) (State) (Zip)
Explanation of Responses:
1. As described in the issuer's registration statement on Form S-1 (File No. 333-256725) under the heading "Description of Securities--Founder Shares," the Class B ordinary shares, par value $0.0001 per share, of the issuer will automatically convert into Class A ordinary shares, par value $0.0001 per share, of the issuer at the time of the issuer's initial business combination, or earlier at the option of the holder, on a one-for-one basis, subject to certain adjustment, and have no expiration date. Includes 825,000 Class B ordinary shares that are subject to forfeiture if the underwriters of the issuer's initial public offering do not exercise in full their option to purchase additional Class A ordinary shares.
2. The reporting owner, SCS Sponsor III LLC (the "Sponsor"), in whose name the securities reported herein are held, is managed by its managers, Chamath Palihapitiya and Kishan Mehta. A majority of the voting interests of the Sponsor are held by ChaChaCha DNA III, LLC ("ChaChaCha"), which is controlled by Mr. Palihapitiya. Messrs. Mehta and Cowen may be deemed to control the other member of the Sponsor. Messrs. Palihapitiya, Mehta and Cowen and ChaChaCha may be deemed to beneficially own shares held by the Sponsor by virtue of their direct or indirect interests in the Sponsor or their shared control over the Sponsor, as the case may be. Each of Mr. Palihapitiya, Mr. Mehta, ChaChaCha and Mr. Cowen disclaims beneficial ownership of the shares held by the Sponsor, except to the extent of such person's pecuniary interest therein.
Remarks:
Exhibit 24.1 - Powers of Attorney. On the basis of the relationship between the Sponsor, ChaChaCha and Messrs. Palihapitiya and Mehta, the Sponsor and ChaChaCha will be deemed directors by deputization.
SCS SPONSOR III, LLC, By: /s/ James Ryans, as Chief Financial Officer CHACHACHA DNA III, LLC, AARON COWEN, CHAMATH PALIHAPITIYA, and KISHAN MEHTA, By: /s/ James Ryans, as attorney-in-fact 06/29/2021
** 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.
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.
POWER OF ATTORNEY
For Executing Forms 3, 4 and 5

KNOW ALL BY THESE PRESENTS, that the undersigned hereby
constitutes and appoints each of Chamath Palihapitiya, James
Ryans and Shoney Katz, or any of them, each acting alone, his or
her true and lawful attorney-in-fact to:

(1) execute for and on behalf of the
undersigned a Form 3, Form 4 or Form 5, or
any amendment thereto, relating to the
securities of Social Capital Suvretta
Holdings Corp. III, in accordance with Section
16(a) of the Securities Exchange Act of 1934
and the rules thereunder;

(2) do and perform any and all acts for and
on behalf of the undersigned which may be
necessary or desirable to complete and
execute such Form 3, Form 4 or Form 5, or
any amendment thereto, and the timely filing
of such form with the United States
Securities and Exchange Commission and any
other authority; and

(3) take any other action of any type
whatsoever in connection with the foregoing
which, in the opinion of such attorney-in-
fact, may be of benefit to, in the best
interest of, or legally required by, the
undersigned, it being understood that the
documents executed by such attorney-in-fact
on behalf of the undersigned pursuant to
this Power of Attorney shall be in such form
and shall contain such terms and conditions
as such attorney-in-fact may approve in such
attorney-in-fact's discretion.

The undersigned hereby grants to each such attorney-in-fact full
power and authority to do and perform any and every act and
thing whatsoever requisite, necessary and proper to be done in
the exercise of any of the rights and powers herein granted, as
fully to all intents and purposes as such undersigned might or
could do if personally present, hereby ratifying and confirming
all that such attorney-in-fact shall lawfully do or cause to be
done by virtue of this Power of Attorney and the rights and
powers herein granted. The undersigned acknowledges that each of
the foregoing attorneys-in-fact, in serving in such capacity at
the request of the undersigned, is not assuming any of the
undersigned's responsibilities to comply with Section 16 of the
Securities Exchange Act of 1934. This Power of Attorney shall
remain in full force and effect until the undersigned is no
longer required to file Forms 3, 4 and 5 with respect to the
undersigned's holdings of and transactions in securities issued
by Social Capital Suvretta Holdings Corp. III unless earlier
revoked by the undersigned in a signed writing delivered to the
foregoing attorneys-in-fact.

IN WITNESS WHEREOF, the undersigned has caused this Power of
Attorney to be executed as of this 28th day of June, 2021.

By: /s/ Kishan Mehta
Name:  Kishan Mehta




POWER OF ATTORNEY
For Executing Forms 3, 4 and 5

KNOW ALL BY THESE PRESENTS, that the undersigned hereby
constitutes and appoints each of Kishan Mehta, James Ryans and
Shoney Katz, or any of them, each acting alone, his or
her true and lawful attorney-in-fact to:

(1) execute for and on behalf of the
undersigned a Form 3, Form 4 or Form 5, or
any amendment thereto, relating to the
securities of Social Capital Suvretta
Holdings Corp. III, in accordance with Section
16(a) of the Securities Exchange Act of 1934
and the rules thereunder;

(2) do and perform any and all acts for and
on behalf of the undersigned which may be
necessary or desirable to complete and
execute such Form 3, Form 4 or Form 5, or
any amendment thereto, and the timely filing
of such form with the United States
Securities and Exchange Commission and any
other authority; and

(3) take any other action of any type
whatsoever in connection with the foregoing
which, in the opinion of such attorney-in-
fact, may be of benefit to, in the best
interest of, or legally required by, the
undersigned, it being understood that the
documents executed by such attorney-in-fact
on behalf of the undersigned pursuant to
this Power of Attorney shall be in such form
and shall contain such terms and conditions
as such attorney-in-fact may approve in such
attorney-in-fact's discretion.

The undersigned hereby grants to each such attorney-in-fact full
power and authority to do and perform any and every act and
thing whatsoever requisite, necessary and proper to be done in
the exercise of any of the rights and powers herein granted, as
fully to all intents and purposes as such undersigned might or
could do if personally present, hereby ratifying and confirming
all that such attorney-in-fact shall lawfully do or cause to be
done by virtue of this Power of Attorney and the rights and
powers herein granted. The undersigned acknowledges that each of
the foregoing attorneys-in-fact, in serving in such capacity at
the request of the undersigned, is not assuming any of the
undersigned's responsibilities to comply with Section 16 of the
Securities Exchange Act of 1934. This Power of Attorney shall
remain in full force and effect until the undersigned is no
longer required to file Forms 3, 4 and 5 with respect to the
undersigned's holdings of and transactions in securities issued
by Social Capital Suvretta Holdings Corp. III unless earlier
revoked by the undersigned in a signed writing delivered to the
foregoing attorneys-in-fact.

IN WITNESS WHEREOF, the undersigned has caused this Power of
Attorney to be executed as of this 28th day of June, 2021.

By: /s/ Chamath Palihapitiya
Name:  Chamath Palihapitiya



POWER OF ATTORNEY
For Executing Forms 3, 4 and 5

KNOW ALL BY THESE PRESENTS, that the undersigned hereby
constitutes and appoints each of Chamath Palihapitiya, Kishan
Mehta, James Ryans and Shoney Katz, or any of them, each acting
alone, his or her true and lawful attorney-in-fact to:

(1) execute for and on behalf of the
undersigned a Form 3, Form 4 or Form 5, or
any amendment thereto, relating to the
securities of Social Capital Suvretta
Holdings Corp. III, in accordance with Section
16(a) of the Securities Exchange Act of 1934
and the rules thereunder;

(2) do and perform any and all acts for and
on behalf of the undersigned which may be
necessary or desirable to complete and
execute such Form 3, Form 4 or Form 5, or
any amendment thereto, and the timely filing
of such form with the United States
Securities and Exchange Commission and any
other authority; and

(3) take any other action of any type
whatsoever in connection with the foregoing
which, in the opinion of such attorney-in-
fact, may be of benefit to, in the best
interest of, or legally required by, the
undersigned, it being understood that the
documents executed by such attorney-in-fact
on behalf of the undersigned pursuant to
this Power of Attorney shall be in such form
and shall contain such terms and conditions
as such attorney-in-fact may approve in such
attorney-in-fact's discretion.

The undersigned hereby grants to each such attorney-in-fact full
power and authority to do and perform any and every act and
thing whatsoever requisite, necessary and proper to be done in
the exercise of any of the rights and powers herein granted, as
fully to all intents and purposes as such undersigned might or
could do if personally present, hereby ratifying and confirming
all that such attorney-in-fact shall lawfully do or cause to be
done by virtue of this Power of Attorney and the rights and
powers herein granted. The undersigned acknowledges that each of
the foregoing attorneys-in-fact, in serving in such capacity at
the request of the undersigned, is not assuming any of the
undersigned's responsibilities to comply with Section 16 of the
Securities Exchange Act of 1934. This Power of Attorney shall
remain in full force and effect until the undersigned is no
longer required to file Forms 3, 4 and 5 with respect to the
undersigned's holdings of and transactions in securities issued
by Social Capital Suvretta Holdings Corp. III unless earlier
revoked by the undersigned in a signed writing delivered to the
foregoing attorneys-in-fact.

IN WITNESS WHEREOF, the undersigned has caused this Power of
Attorney to be executed as of this 28th day of June, 2021.

By: /s/ Aaron Cowen
Name:  Aaron Cowen