0001181431-12-017560.txt : 20120315
0001181431-12-017560.hdr.sgml : 20120315
20120315103247
ACCESSION NUMBER: 0001181431-12-017560
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20120313
FILED AS OF DATE: 20120315
DATE AS OF CHANGE: 20120315
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: BALSON ANDREW
CENTRAL INDEX KEY: 0001212449
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35004
FILM NUMBER: 12692572
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: FLEETCOR TECHNOLOGIES INC
CENTRAL INDEX KEY: 0001175454
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-BUSINESS SERVICES, NEC [7389]
IRS NUMBER: 000000000
STATE OF INCORPORATION: DE
BUSINESS ADDRESS:
STREET 1: 5445 TRIANGLE PARKWAY
STREET 2: SUITE 400
CITY: NORCROSS
STATE: GA
ZIP: 30092
BUSINESS PHONE: 800-877-9019
MAIL ADDRESS:
STREET 1: 5445 TRIANGLE PARKWAY
STREET 2: SUITE 400
CITY: NORCROSS
STATE: GA
ZIP: 30092
4
1
rrd338685.xml
FORM 4
X0304
4
2012-03-13
0
0001175454
FLEETCOR TECHNOLOGIES INC
FLT
0001212449
BALSON ANDREW
C/O BAIN CAPITAL PARTNERS, LLC
JOHN HANCOCK TOWER, 200 CLARENDON STREET
BOSTON
MA
02116
1
0
1
0
Common Stock
2012-03-13
4
J
0
246258
0
D
11085074
I
See Footnotes
Common Stock
2012-03-13
4
J
0
16522
0
A
16522
D
Common Stock
2012-03-13
4
G
0
16522
0
D
0
D
Common Stock
2012-03-13
4
S
0
1753742
36.02
D
9331332
I
See Footnotes
Andrew Balson is a Managing Director of Bain Capital Investors, LLC ("BCI"). BCI is the sole general partner of Bain Capital Partners VIII, L.P. ("BCP VIII"), which is the sole general partner of Bain Capital Fund VIII, L.P. ("BCF VIII"), which is the sole member of Bain Capital Fund VIII, LLC ("Fund VIII").
BCI is also the managing partner of BCIP Associates III, which is the sole manager of BCIP Associates III, LLC ("BCIP-A").
BCI is also the managing partner of BCIP Trust Associates III, which is the sole manager of BCIP T Associates III, LLC ("BCIP-TA").
BCI is also the managing partner of BCIP Associates III-B, which is the sole manager of BCIP Associates III-B, LLC ("BCIP-AB").
BCI is also the managing partner of BCIP Trust Associates III-B, which is the sole manager of BCIP T Associates III-B, LLC ("BCIP-TAB").
BCI is also the managing partner of BCIP Associates-G ("BCIP-AG" and together with BCF, BCIP-A, BCIP-TA, BCIP-AB and BCIP-TAB, the "Bain Entities").
By virtue of the relationships described in the foregoing footnotes, Mr. Balson may be deemed to share voting and dispositive power with respect to all of the Issuer's securities held by the Bain Entities. Mr. Balson disclaims beneficial ownership of the Issuer's securities held by each of the Bain Entities except to the extent of his pecuniary interest therein.
On March 13, 2012, the Bain Entities distributed 246,258 shares of Common Stock to one or more members or partners of the Bain Entities in connection with certain charitable gifts made by such members or partners on March 13, 2012, including 16,522 shares of Common Stock to Mr. Balson, all of which were gifted by Mr. Balson to charity on March 13, 2012.
/s/ Andrew Balson
2012-03-14