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