0001179110-18-007609.txt : 20180529 0001179110-18-007609.hdr.sgml : 20180529 20180529161015 ACCESSION NUMBER: 0001179110-18-007609 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20180524 FILED AS OF DATE: 20180529 DATE AS OF CHANGE: 20180529 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: 18864525 MAIL ADDRESS: STREET 1: 465 BRICKELL AVENUE #4203 CITY: MIAMI STATE: FL ZIP: 33131 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 4 1 edgar.xml FORM 4 - X0306 4 2018-05-24 0 0001657197 Cotiviti Holdings, Inc. COTV 0001295959 King-Shaw Ruben Jose JR C/O COTIVITI HOLDINGS, INC. ONE GLENLAKE PARKWAY, SUITE 1400 ATLANTA GA 30328 1 0 0 0 Common Stock, par value $0.001 per share 2018-05-24 4 M 0 4189 A 7878 D Restricted Stock Units 2018-05-24 4 M 0 4189 0 A Common Stock, par value $0.001 per share 4189 0 D Restricted Stock Units convert into Common Stock on a one-for-one basis. On June 1, 2017, the Reporting Person was granted 4,189 Restricted Stock Units all of which vested on May 24, 2018, the date of Cotiviti Holdings, Inc.'s first annual meeting following the date of grant. /s/ Jonathan Olefson, attorney-in-fact 2018-05-29