0001209191-20-042940.txt : 20200717
0001209191-20-042940.hdr.sgml : 20200717
20200717180027
ACCESSION NUMBER: 0001209191-20-042940
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20200715
FILED AS OF DATE: 20200717
DATE AS OF CHANGE: 20200717
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Norwest Venture Partners XI, LP
CENTRAL INDEX KEY: 0001534522
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38993
FILM NUMBER: 201034580
BUSINESS ADDRESS:
STREET 1: 525 UNIVERSITY AVENUE
STREET 2: SUITE 800
CITY: PALO ALTO
STATE: CA
ZIP: 94301
BUSINESS PHONE: 650-321-8000
MAIL ADDRESS:
STREET 1: 525 UNIVERSITY AVENUE
STREET 2: SUITE 800
CITY: PALO ALTO
STATE: CA
ZIP: 94301
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Norwest Venture Partners XII, LP
CENTRAL INDEX KEY: 0001614660
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38993
FILM NUMBER: 201034581
BUSINESS ADDRESS:
STREET 1: 525 UNIVERSITY AVENUE, SUITE 800
CITY: PALO ALTO
STATE: CA
ZIP: 94301
BUSINESS PHONE: 650-321-8000
MAIL ADDRESS:
STREET 1: 525 UNIVERSITY AVENUE, SUITE 800
CITY: PALO ALTO
STATE: CA
ZIP: 94301
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Crowe Jeffrey
CENTRAL INDEX KEY: 0001535261
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38993
FILM NUMBER: 201034582
MAIL ADDRESS:
STREET 1: 525 UNIVERSITY AVENUE
STREET 2: SUITE 800
CITY: PALO ALTO
STATE: CA
ZIP: 94301
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Kossow Jon Erik
CENTRAL INDEX KEY: 0001726084
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38993
FILM NUMBER: 201034583
MAIL ADDRESS:
STREET 1: 525 UNIVERSITY AVENUE, SUITE 800
CITY: PALO ALTO
STATE: CA
ZIP: 94025
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Health Catalyst, Inc.
CENTRAL INDEX KEY: 0001636422
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMPUTER PROGRAMMING, DATA PROCESSING, ETC. [7370]
IRS NUMBER: 453337483
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 3165 E. MILLROCK, SUITE 400
CITY: SALT LAKE CITY
STATE: UT
ZIP: 84121
BUSINESS PHONE: 801-708-6800
MAIL ADDRESS:
STREET 1: 3165 E. MILLROCK, SUITE 400
CITY: SALT LAKE CITY
STATE: UT
ZIP: 84121
FORMER COMPANY:
FORMER CONFORMED NAME: HQC Holdings, Inc.
DATE OF NAME CHANGE: 20150312
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2020-07-15
1
0001636422
Health Catalyst, Inc.
HCAT
0001534522
Norwest Venture Partners XI, LP
525 UNIVERSITY AVENUE
SUITE 800
PALO ALTO
CA
94301
0
0
1
0
0001614660
Norwest Venture Partners XII, LP
525 UNIVERSITY AVENUE, SUITE 800
PALO ALTO
CA
94301
0
0
1
0
0001535261
Crowe Jeffrey
525 UNIVERSITY AVENUE
SUITE 800
PALO ALTO
CA
94301
0
0
1
0
0001726084
Kossow Jon Erik
525 UNIVERSITY AVENUE
SUITE 800
PALO ALTO
CA
94301
0
0
1
0
Common Stock
2020-07-15
4
J
0
599939
0.00
D
1752214
D
Common Stock
2020-07-15
4
J
0
600000
0.00
D
1752090
I
By Limited Partnership
Shares were disposed of via a pro rata in-kind distribution of Issuer's stock from Norwest Venture Partners XI, LP ("NVP XI") to its limited partners.
The NVP XI distribution resulted in a change in the form of beneficial ownership so that following the distribution 123 shares were beneficially owned by Kossow Family Trust, of which Mr. Kossow is a Trustee. The remaining 1,752,091 shares are held of record by NVP XI. Genesis VC Partners XI, LLC ("Genesis XI") is the general partner of NVP XI and may be deemed to have sole voting and dispositive power over the shares held by NVP XI. NVP Associates, LLC ("NVP Associates"), the managing member of Genesis XI, and Jeffrey Crowe and Jon E. Kossow, as Co-Chief Executive Officers of NVP Associates, may be deemed to share voting and dispositive power with respect to such securities. Such entities, Crowe and Kossow disclaim beneficial ownership of all such securities, except to the extent of any pecuniary interest therein.
Shares were disposed of via a pro rata in-kind distribution of Issuer's stock from Norwest Venture Partners XII, LP ("NVP XII") to its limited partners.
The securities shown on Line 2 of Table I represent securities held of record by NVP XII. Genesis VC Partners XII, LLC ("Genesis XII") is the general partner of NVP XII and may be deemed to have sole voting and dispositive power over the shares held by NVP XII. NVP Associates, the managing member of Genesis XII, and Jeffrey Crowe and Jon E. Kossow, as Co-Chief Executive Officers of NVP Associates, may be deemed to share voting and dispositive power with respect to such securities. Such entities, Crowe and Kossow disclaim beneficial ownership of all such securities, except to the extent of any pecuniary interest therein.
/s/ Matthew De Dominicis, Chief Financial Officer
2020-07-17