0001179110-17-008440.txt : 20170602 0001179110-17-008440.hdr.sgml : 20170602 20170602161834 ACCESSION NUMBER: 0001179110-17-008440 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170601 FILED AS OF DATE: 20170602 DATE AS OF CHANGE: 20170602 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Cotiviti Holdings, Inc. CENTRAL INDEX KEY: 0001657197 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-BUSINESS SERVICES, NEC [7389] IRS NUMBER: 460595918 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 115 PERIMETER CENTER PLACE STREET 2: SUITE 700 CITY: ATLANTA STATE: GA ZIP: 30346 BUSINESS PHONE: 770 379-2800 MAIL ADDRESS: STREET 1: 115 PERIMETER CENTER PLACE STREET 2: SUITE 700 CITY: ATLANTA STATE: GA ZIP: 30346 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: King-Shaw Ruben Jose JR CENTRAL INDEX KEY: 0001295959 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37787 FILM NUMBER: 17888196 MAIL ADDRESS: STREET 1: 465 BRICKELL AVENUE #4203 CITY: MIAMI STATE: FL ZIP: 33131 4 1 edgar.xml FORM 4 - X0306 4 2017-06-01 0 0001657197 Cotiviti Holdings, Inc. COTV 0001295959 King-Shaw Ruben Jose JR C/O COTIVITI HOLDINGS, INC. 115 PERIMETER CENTER PLACE, SUITE 700 ATLANTA GA 30346 1 0 0 0 Restricted Stock Units 2017-06-01 4 A 0 4189 0 A Common Stock, par value $0.001 4189 4189 D Each Restricted Stock Unit represents the right to receive, at settlement, one (1) share of Common Stock, par value $0.001 per share. The Restricted Stock Units vest on the date of Cotiviti Holdings, Inc.'s first annual meeting of stockholders following the date of grant, June 1, 2017, subject to the Reporting Person's continued service through the vesting date. /s/ Jonathan Olefson, attorney-in-fact 2017-06-02