0001181431-12-061124.txt : 20121129
0001181431-12-061124.hdr.sgml : 20121129
20121129165114
ACCESSION NUMBER: 0001181431-12-061124
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20121127
FILED AS OF DATE: 20121129
DATE AS OF CHANGE: 20121129
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: 121232338
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
rrd361679.xml
FORM 4
X0306
4
2012-11-27
0
0001175454
FLEETCOR TECHNOLOGIES INC
FLT
0001212449
BALSON ANDREW
C/O BAIN CAPITAL INVESTORS, LLC
JOHN HANCOCK TOWER, 200 CLARENDON STREET
BOSTON
MA
02116
1
0
0
0
Common Stock
2012-11-27
4
J
0
198257
0.00
D
7133075
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 Fund VIII, 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 beneficially own securities held by the Bain Entities. Mr. Balson disclaims beneficial ownership of such securities except to the extent of his pecuniary interest therein.
On November 27, 2012, the Bain Entities distributed 198,257 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 November 27, 2012.
/s/ Andrew Balson
2012-11-29