0000899243-16-012914.txt : 20160209 0000899243-16-012914.hdr.sgml : 20160209 20160209170024 ACCESSION NUMBER: 0000899243-16-012914 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20160205 FILED AS OF DATE: 20160209 DATE AS OF CHANGE: 20160209 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Acadia Healthcare Company, Inc. CENTRAL INDEX KEY: 0001520697 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-SPECIALTY OUTPATIENT FACILITIES, NEC [8093] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 6100 TOWER CIRCLE STREET 2: SUITE 1000 CITY: FRANKLIN STATE: TN ZIP: 37067 BUSINESS PHONE: 615-861-6000 MAIL ADDRESS: STREET 1: 6100 TOWER CIRCLE STREET 2: SUITE 1000 CITY: FRANKLIN STATE: TN ZIP: 37067 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: JACOBS JOEY A CENTRAL INDEX KEY: 0001243878 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35331 FILM NUMBER: 161400788 MAIL ADDRESS: STREET 1: 830 CRESCENT CENTER DRIVE STREET 2: SUITE 610 CITY: FRANKLIN STATE: TN ZIP: 37067 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2016-02-05 0 0001520697 Acadia Healthcare Company, Inc. ACHC 0001243878 JACOBS JOEY A ACADIA HEALTHCARE COMPANY, INC. 6100 TOWER CIRCLE, SUITE 1000 FRANKLIN TN 37067 1 1 1 0 Chief Executive Officer Common Stock 2016-02-05 4 A 0 27797 0.00 A 295752 D Common Stock 567649 I See Footnote Shares will vest over a 4-year period in equal annual installments beginning February 5, 2017. Mr. Jacobs expressly disclaims beneficial ownership of the reported securities, except to the extent of his pecuniary interest therein. By the Jeremy Brent Jacobs GST Non-Exempt u/a/d 04/26/2011 and Scott Douglas Jacobs GST Non-Exempt Trust u/a/d 04/26/2011. The reporting person is party to a stockholders agreement with Acadia Healthcare Company, Inc. ("Acadia") and certain other stockholders. As a result, he may be deemed to be a part of a "group" with such other stockholders. To the extent the reporting person is deemed a member of a group, he disclaims beneficial ownership of shares owned by other members of the group. /s/ Christopher L. Howard as Attorney in Fact for Joey A. Jacobs 2016-02-09