0001179110-18-002651.txt : 20180222
0001179110-18-002651.hdr.sgml : 20180222
20180222192056
ACCESSION NUMBER: 0001179110-18-002651
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20180122
FILED AS OF DATE: 20180222
DATE AS OF CHANGE: 20180222
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: LUBIN DANIEL C
CENTRAL INDEX KEY: 0001335280
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37888
FILM NUMBER: 18634252
MAIL ADDRESS:
STREET 1: RADIUS VENTURE PARTNERS II LLC
STREET 2: 400 MADISON AVE 8TH FLOOR
CITY: NEW YORK
STATE: NY
ZIP: 10017
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Tabula Rasa HealthCare, Inc.
CENTRAL INDEX KEY: 0001651561
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-BUSINESS SERVICES, NEC [7389]
IRS NUMBER: 465726437
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 228 STRAWBRIDGE DRIVE
STREET 2: SUITE 100
CITY: MOORESTOWN
STATE: NJ
ZIP: 08057
BUSINESS PHONE: 866-648-2767
MAIL ADDRESS:
STREET 1: 228 STRAWBRIDGE DRIVE
STREET 2: SUITE 100
CITY: MOORESTOWN
STATE: NJ
ZIP: 08057
4
1
edgar.xml
FORM 4 -
X0306
4
2018-01-22
1
0001651561
Tabula Rasa HealthCare, Inc.
TRHC
0001335280
LUBIN DANIEL C
250 PARK AVENUE
SUITE 1102
NEW YORK
NY
10177
0
0
0
1
Former Director
Common Stock
121717
I
By Radius Venture Partners III (Ohio), L.P.
Common Stock
969144
I
By Radius Venture Partners III QP, L.P.
Common Stock
88875
I
By Radius Venture Partners III, L.P.
Common Stock
3091
D
These securities are held directly by Radius Venture Partners III (Ohio), L.P. and indirectly by Radius Venture Partners III, LLC, the general partner of Radius Venture Partners III (Ohio), L.P., Jordan S. Davis, managing member of Radius Venture Partners III, LLC, and Daniel C. Lubin, managing member of Radius Venture Partners III, LLC. Mr. Lubin, a director of the Issuer, and Mr. Davis share voting and dispositive power with respect to the shares held by Radius Venture Partners III (Ohio), L.P. Each of Radius Venture Partners III, LLC, Mr. Davis, and Mr. Lubin may be deemed to beneficially own such securities, and disclaims such beneficial ownership except to the extent of its or his pecuniary interest therein.
These securities are held directly by Radius Venture Partners III QP, L.P and indirectly by Radius Venture Partners III, LLC, the general partner of Radius Venture Partners III QP, L.P., Jordan S. Davis, managing member of Radius Venture Partners III, LLC, and Daniel C. Lubin, managing member of Radius Venture Partners III, LLC. Mr. Lubin, a director of the Issuer, and Mr. Davis share voting and dispositive power with respect to the shares held by Radius Venture Partners III QP, L.P. Each of Radius Venture Partners III, LLC, Mr. Davis, and Mr. Lubin may be deemed to beneficially own such securities, and disclaims such beneficial ownership except to the extent of its or his pecuniary interest therein.
These securities are held directly by Radius Venture Partners III, L.P., and indirectly by Radius Venture Partners III, LLC, the general partner of Radius Venture Partners III, L.P., Jordan S. Davis, managing member of Radius Venture Partners III, LLC, and Daniel C. Lubin, managing member of Radius Venture Partners III, LLC. Mr. Lubin, a director of the Issuer, and Mr. Davis share voting and dispositive power with respect to the shares held by Radius Venture Partners III, L.P. Each of Radius Venture Partners III, LLC, Mr. Davis, and Mr. Lubin may be deemed to beneficially own such securities, and disclaims such beneficial ownership except to the extent of its or his pecuniary interest therein.
Pursuant to the terms of the award pertaining to shares of restricted common stock issued to the reporting person on September 28, 2016 pursuant to the issuer's 2016 Omnibus Incentive Compensation Plan, 2,474 of the shares were forfeited in connection with the reporting person's resignation as a director.
The reporting person resigned from his position as a director of the issuer effective January 22, 2018. As a result, this Form 4 serves as his exit filing.
/s/ Daniel C. Lubin
2018-02-22