0001209191-17-048748.txt : 20170814
0001209191-17-048748.hdr.sgml : 20170814
20170814160852
ACCESSION NUMBER: 0001209191-17-048748
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20170810
FILED AS OF DATE: 20170814
DATE AS OF CHANGE: 20170814
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Maldonado John L.
CENTRAL INDEX KEY: 0001544918
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37787
FILM NUMBER: 171030186
MAIL ADDRESS:
STREET 1: C/O ADVENT INTERNATIONAL CORPORATION
STREET 2: 75 STATE STREET, 29TH FLOOR
CITY: BOSTON
STATE: MA
ZIP: 02109
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
doc4.xml
FORM 4 SUBMISSION
X0306
4
2017-08-10
0
0001657197
Cotiviti Holdings, Inc.
COTV
0001544918
Maldonado John L.
C/O ADVENT INTERNATIONAL CORPORATION
75 STATE STREET, 29TH FLOOR
BOSTON
MA
02109
1
0
0
0
Common Stock
2017-08-10
4
S
0
9257651
36.87
D
41433699
I
See Footnotes
The Reporting Person is a Managing Partner at Advent International Corporation ("AIC") and in addition may have limited partnership or other interests in one or more of the Advent Entities (as defined below). AIC manages funds that collectively own 41,433,699 shares (the "Shares"), which are represented as follows: 17,778,618 shares held directly by Advent-Cotiviti Acquisition Limited Partnership, 18,817,920 held directly by Advent-Cotiviti Acquisition II Limited Partnership, 918,209 shares directly owned by Advent International GPE VI-C Limited Partnership, 875,864 shares directly owned by Advent International GPE VI-D Limited Partnership, 2,215,460 shares directly owned by Advent International GPE VI-E Limited Partnership, 651,453 shares directly owned by Advent Partners GPE VI 2008 Limited Partnership, (CONTINUED IN NEXT FOOTNOTE)
CONTINUED FROM PREVIOUS FOOTNOTE) 19,762 shares directly owned by Advent Partners GPE VI 2009 Limited Partnership 46,608 shares directly owned by Advent Partners GPE VI 2010 Limited Partnership, 51,762 shares directly owned by Advent Partners GPE VI-A 2010 Limited Partnership and 58,043 shares directly owned by Advent Partners GPE VI-A Limited Partnership (collectively and together with certain other affiliates of Advent, the "Advent Entities"). The Reporting Person disclaims Section 16 beneficial ownership of the Shares except to the extent of his pecuniary interest therein, if any, and the reference to these Shares in this report shall not be deemed an admission of beneficial ownership of all of the Shares for purposes of Section 16 or any other purpose.
/s/ Richard Terranova, Attorney-in-Fact
2017-08-14