0001140361-22-043166.txt : 20221125 0001140361-22-043166.hdr.sgml : 20221125 20221125210425 ACCESSION NUMBER: 0001140361-22-043166 CONFORMED SUBMISSION TYPE: 3/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210616 FILED AS OF DATE: 20221125 DATE AS OF CHANGE: 20221125 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: LARSEN JOHN L CENTRAL INDEX KEY: 0001065871 FILING VALUES: FORM TYPE: 3/A SEC ACT: 1934 Act SEC FILE NUMBER: 001-39439 FILM NUMBER: 221421009 MAIL ADDRESS: STREET 1: C/O ATI PHYSICAL THERAPY STREET 2: 790 REMINGTON BLVD. CITY: BOLINGBROOK STATE: IL ZIP: 60440-4909 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: ATI Physical Therapy, Inc. CENTRAL INDEX KEY: 0001815849 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-NURSING & PERSONAL CARE FACILITIES [8050] IRS NUMBER: 851408039 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 790 REMINGTON BOULEVARD CITY: BOILINGBROOK STATE: IL ZIP: 60440 BUSINESS PHONE: 630-296-2223 MAIL ADDRESS: STREET 1: 790 REMINGTON BOULEVARD CITY: BOILINGBROOK STATE: IL ZIP: 60440 FORMER COMPANY: FORMER CONFORMED NAME: Fortress Value Acquisition Corp. II DATE OF NAME CHANGE: 20200622 3/A 1 form3.xml X0206 3/A 2021-06-16 2021-06-28 0 0001815849 ATI Physical Therapy, Inc. ATIP 0001065871 LARSEN JOHN L C/O ATI PHYSICAL THERAPY 790 REMINGTON BBOULEVARD BOLINGBROOK IL 60440 true Class A Common Stock 16143 D Time-vested restricted stock which was inadvertently omitted from the Reporting Person's Form 3 filed on June 28, 2021. /s/John Lines as Attorney-in-Fact for Reporting Person 2022-11-25