0001213900-16-015000.txt : 20160714 0001213900-16-015000.hdr.sgml : 20160714 20160714214220 ACCESSION NUMBER: 0001213900-16-015000 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20160714 FILED AS OF DATE: 20160714 DATE AS OF CHANGE: 20160714 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Conyers Park Acquisition Corp. CENTRAL INDEX KEY: 0001672985 STANDARD INDUSTRIAL CLASSIFICATION: BLANK CHECKS [6770] IRS NUMBER: 812349205 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 31 WEST 52ND STREET STREET 2: 22ND FLOOR CITY: NEW YORK STATE: NY ZIP: 10019 BUSINESS PHONE: 212-380-2644 MAIL ADDRESS: STREET 1: 31 WEST 52ND STREET STREET 2: 22ND FLOOR CITY: NEW YORK STATE: NY ZIP: 10019 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: KILTS JAMES M CENTRAL INDEX KEY: 0001025094 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37828 FILM NUMBER: 161768403 MAIL ADDRESS: STREET 2: 120 PARK AVE CITY: NEW YORK STATE: NY ZIP: 10017 3 1 f3071416kilts_conyerspark.xml OWNERSHIP DOCUMENT X0206 3 2016-07-14 0 0001672985 Conyers Park Acquisition Corp. CPAA 0001025094 KILTS JAMES M 3 GREENWICH OFFICE PARK, 2ND FLOOR GREENWICH CT 06831 1 0 0 0 Class B Common Stock Class A Common Stock 0 I see footnote Mr. Kilts does not beneficially own any shares of the common stock of the issuer. However, Mr. Kilts has a pecuniary interest in shares of Class B common stock through his ownership of membership interests of Conyers Park Sponsor LLC. As described in the issuer's registration statement on Form S-1 (File No. 333-212133) under the heading "Description of Securities--Founder Shares", the shares of Class B common stock will automatically convert into shares of Class A common stock 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 adjustment for stock splits, stock dividends, reorganizations, recapitalizations and the like, and certain anti-dilution rights and has no expiration date. /s/ James M. Kilts 2016-07-14