0000899243-21-046163.txt : 20211126 0000899243-21-046163.hdr.sgml : 20211126 20211126175141 ACCESSION NUMBER: 0000899243-21-046163 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211123 FILED AS OF DATE: 20211126 DATE AS OF CHANGE: 20211126 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Parisi James E. CENTRAL INDEX KEY: 0001307171 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39439 FILM NUMBER: 211452360 MAIL ADDRESS: STREET 1: C/O COTIVITI HOLDINGS, INC. STREET 2: 115 PERIMETER CENTER PLACE, SUITE 700 CITY: ATLANTA STATE: GA ZIP: 30346 FORMER NAME: FORMER CONFORMED NAME: Parisi Jamie DATE OF NAME CHANGE: 20041027 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: ATI Physical Therapy, Inc. CENTRAL INDEX KEY: 0001815849 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-NURSING & PERSONAL CARE FACILITIES [8050] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 790 REMINGTON BOULEVARD CITY: BOILINGBROOK STATE: IL ZIP: 60440 BUSINESS PHONE: 702-844-6111 MAIL ADDRESS: STREET 1: 790 REMINGTON BOULEVARD CITY: BOILINGBROOK STATE: IL ZIP: 60440 FORMER COMPANY: FORMER CONFORMED NAME: Fortress Value Acquisition Corp. II DATE OF NAME CHANGE: 20200622 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2021-11-23 0 0001815849 ATI Physical Therapy, Inc. ATIP 0001307171 Parisi James E. C/O ATI PHYSICAL THERAPY 790 REMINGTON BOULEVARD BOLINGBROOK IL 60440 1 0 0 0 Class A common stock 2021-11-23 4 A 0 14620 0.00 A 14620 D Stock Option (right to buy) 3.42 2021-11-23 4 A 0 27962 0.00 A 2031-11-23 Class A common stock 27962 27962 D One-third of the Stock Options vest on each of the first three anniversaries of June 16, 2021, each subject to the Reporting Person's continued service through the applicable vesting date. /s/ Erik Kantz, as Attorney-In-Fact for Reporting Person 2021-11-26