0001387131-19-009745.txt : 20191219
0001387131-19-009745.hdr.sgml : 20191219
20191219214305
ACCESSION NUMBER: 0001387131-19-009745
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20191218
FILED AS OF DATE: 20191219
DATE AS OF CHANGE: 20191219
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Forman Michael C.
CENTRAL INDEX KEY: 0001438253
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-55121
FILM NUMBER: 191297558
MAIL ADDRESS:
STREET 1: CIRA CENTRE
STREET 2: 2929 ARCH STREET, SUITE 675
CITY: PHILADELPHIA
STATE: PA
ZIP: 19104-2867
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: FS Investment Corp III
CENTRAL INDEX KEY: 0001579412
IRS NUMBER: 900994912
STATE OF INCORPORATION: MD
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 201 ROUSE BOULEVARD
CITY: PHILADELPHIA
STATE: PA
ZIP: 19112
BUSINESS PHONE: 215-495-1150
MAIL ADDRESS:
STREET 1: 201 ROUSE BOULEVARD
CITY: PHILADELPHIA
STATE: PA
ZIP: 19112
4
1
formanfsiciii-form4_121819.xml
OWNERSHIP DOCUMENT
X0306
4
2019-12-18
1
0001579412
FS Investment Corp III
NONE
0001438253
Forman Michael C.
C/O FS KKR CAPITAL CORP. II
201 ROUSE BOULEVARD
PHILADELPHIA
PA
19112
1
1
0
0
CEO
Common Stock
2019-12-18
4
D
0
81160
D
0
I
MCFDA SCV LLC
Disposed of in exchange for 79,569 shares of FS KKR Capital Corp II. (f/k/a FS Investment Corp.) ("FSK II") common stock in connection with the closing of the mergers of FSK II, FS Investment Corporation III ("FSIC III"), FS Investment Corporation IV ("FSIC IV") and Corporate Capital Trust II ("CCT II") pursuant to that certain Agreement and Plan of Merger, dated May 31, 2019 (the "Merger Agreement"), by and among FSK II, FSIC III, CCT II, FSIC IV, NT Acquisition 1, Inc., NT Acquisition 2, Inc., NT Acquisition 3, Inc. and FS/KKR Advisor, LLC.
All shares held by MCFDA SCV LLC, which is a wholly-owned special purpose financing vehicle of which The 2011 Forman Investment Trust is a member and Mr. Forman is the manager.
/s/ Stephen S. Sypherd, Attorney-in-Fact
2019-12-19