0001140361-17-027467.txt : 20170707 0001140361-17-027467.hdr.sgml : 20170707 20170707164553 ACCESSION NUMBER: 0001140361-17-027467 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20170705 FILED AS OF DATE: 20170707 DATE AS OF CHANGE: 20170707 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Avista Healthcare Public Acquisition Corp. CENTRAL INDEX KEY: 0001661181 STANDARD INDUSTRIAL CLASSIFICATION: BLANK CHECKS [6770] IRS NUMBER: 000000000 STATE OF INCORPORATION: NY FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 65 EAST 55TH STREET STREET 2: 18TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10022 BUSINESS PHONE: 212 593-6900 MAIL ADDRESS: STREET 1: 65 EAST 55TH STREET STREET 2: 18TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10022 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Burgstahler David F CENTRAL INDEX KEY: 0001374179 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37906 FILM NUMBER: 17955650 MAIL ADDRESS: STREET 1: C/O WARNER CHILCOTT HOLDINGS CO., LTD. STREET 2: 100 ENTERPRISE DRIVE CITY: ROCKAWAY STATE: NJ ZIP: 07866 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Dean Thompson CENTRAL INDEX KEY: 0001069096 STATE OF INCORPORATION: DE FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37906 FILM NUMBER: 17955651 MAIL ADDRESS: STREET 1: 65 EAST 55TH STREET, 18TH FLOOR STREET 2: C/O AVISTA CAPITAL PARTNERS CITY: NEW YORK STATE: NY ZIP: 10022 FORMER NAME: FORMER CONFORMED NAME: DEAN THOMPSON DATE OF NAME CHANGE: 19980827 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Avista Acquisition, LLC CENTRAL INDEX KEY: 0001686388 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37906 FILM NUMBER: 17955652 BUSINESS ADDRESS: STREET 1: 65 EAST 55TH STREET STREET 2: 18TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10022 BUSINESS PHONE: 212-593-6900 MAIL ADDRESS: STREET 1: 65 EAST 55TH STREET STREET 2: 18TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10022 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Avista Acquisition Corp. CENTRAL INDEX KEY: 0001661187 STATE OF INCORPORATION: E9 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37906 FILM NUMBER: 17955653 BUSINESS ADDRESS: STREET 1: 65 EAST 55TH STREET STREET 2: 18TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10022 BUSINESS PHONE: 212 593-6900 MAIL ADDRESS: STREET 1: 65 EAST 55TH STREET STREET 2: 18TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10022 4 1 form4.xml FORM 4 X0306 4 2017-07-05 0001661181 Avista Healthcare Public Acquisition Corp. AHPA 0001661187 Avista Acquisition Corp. C/O AVISTA HEALTHCARE PUBLIC ACQUISITION CORP. 65 EAST 55TH STREET, 18TH FLOOR NEW YORK NY 10022 true 0001686388 Avista Acquisition, LLC C/O AVISTA HEALTHCARE PUBLIC ACQUISITION CORP. 65 EAST 55TH STREET, 18TH FLOOR NEW YORK NY 10022 true 0001069096 Dean Thompson C/O AVISTA HEALTHCARE PUBLIC ACQUISITION CORP. 65 EAST 55TH STREET, 18TH FLOOR NEW YORK NY 10022 true true true Executive Chairman 0001374179 Burgstahler David F C/O AVISTA HEALTHCARE PUBLIC ACQUISITION CORP. 65 EAST 55TH STREET, 18TH FLOOR NEW YORK NY 10022 true true true President and CEO Class B Ordinary Shares 2016-11-28 4 S 0 186320 0.003 D Class A Ordinary Shares 186320 5792500 D Pursuant to the Amended and Restated Memorandum and Articles of Association (the "Articles") of the Issuer, the Class B ordinary shares, par value $0.0001 per share (the "Class B Shares") will automatically convert into Class A ordinary shares, par value $0.0001 per share, of the Issuer at the time of the Issuer's Business Combination, as defined in the Articles, on a one-for-one basis, subject to adjustment, and have no expiration date. Directly owned by Sponsor. The sole shareholder of Sponsor is Avista Acquisition, LLC ("Avista Acquisition"). Thompson Dean and David Burgstahler are the managers of Avista Acquisition (and, together with Sponsor, Messrs. Dean and Burgstahler are the "Reporting Persons"). Because of the relationship among the Reporting Persons, the Reporting Persons may be deemed to beneficially own the securities reported herein to the extent of their respective pecuniary interests. Each Reporting Person disclaims beneficial ownership of the securities reported herein, except to the extent of such Reporting Person's pecuniary interest therein, if any. Pursuant to Rule 16a-1(a)(4) under the Exchange Act, this filing shall not be deemed an admission that the Reporting Persons are, for purposes of Section 16 of the Exchange Act or otherwise, the beneficial owners of any equity securities in excess of their respective pecuniary interests. Exhibit 99.1 Joint Filer Information, incorporated herein by reference. By: /s/ Benjamin Silbert, Attorney-in-Fact for Avista Acquisition Corp 2017-07-07 By: /s/ Benjamin Silbert, Attorney-in-Fact for Avista Acquisition, LLC 2017-07-07 By: /s/ Benjamin Silbert, Attorney-in-Fact for Thompson Dean 2017-07-07 By: /s/ Benjamin Silbert, Attorney-in-Fact for David Burgstahler 2017-07-07 EX-99.1 2 ex99_1.htm EXHIBIT 99.1
Exhibit 99.1


Joint Filer Information


Name of Joint Filer:
  
Avista Acquisition, LLC
     
Address of Joint Filer:
  
c/o Avista Healthcare Public Acquisition Corp.
65 East 55th Street
    
   
18th Floor
   
New York, NY  10022
     
Relationship of Joint Filer to Issuer:
  
10% Owner
     
Issuer Name and Ticker or Trading Symbol:
  
Avista Healthcare Public Acquisition Corp. [AHPA]
     
Date of Event Requiring Statement:
    
(Month/Day/Year):
  
11/25/2016
     
Designated Filer:
  
Avista Acquisition Corp.
     
     
Name of Joint Filer:
  
Thompson Dean
     
Address of Joint Filer:
  
c/o Avista Healthcare Public Acquisition Corp.
65 East 55th Street
    
   
18th Floor
   
New York, NY  10022
     
Relationship of Joint Filer to Issuer:
  
Director; 10% Owner; Officer (Executive Chairman)
     
Issuer Name and Ticker or Trading Symbol:
  
Avista Healthcare Public Acquisition Corp. [AHPA]
     
Date of Event Requiring Statement:
    
(Month/Day/Year):
  
11/25/2016
     
Designated Filer:
  
Avista Acquisition Corp.
     
     
Name of Joint Filer:
  
David Burghstahler
     
Address of Joint Filer:
  
c/o Avista Healthcare Public Acquisition Corp.
65 East 55th Street
    
   
18th Floor
   
New York, NY  10022
     
Relationship of Joint Filer to Issuer:
  
Director; 10% Owner; Officer (President and Chief Executive Officer)
     
Issuer Name and Ticker or Trading Symbol:
  
Avista Healthcare Public Acquisition Corp. [AHPA]
     
Date of Event Requiring Statement:
    
(Month/Day/Year):
  
11/25/2016
     
Designated Filer:
  
Avista Acquisition Corp.