0000899243-16-016412.txt : 20160322 0000899243-16-016412.hdr.sgml : 20160322 20160322180031 ACCESSION NUMBER: 0000899243-16-016412 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20160319 FILED AS OF DATE: 20160322 DATE AS OF CHANGE: 20160322 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: 161521937 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 2016-03-19 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 2016-03-19 4 F 0 2441 52.37 D 335902 D Common Stock 567649 I See Footnote 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. In connection with the merger of Acadia Healthcare Company, Inc. ("Acadia") and PHC, Inc., the reporting person entered into a stockholders agreement with Acadia and certain other stockholders. As a result, he may 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 2016-03-22