0001619954-15-000032.txt : 20150915
0001619954-15-000032.hdr.sgml : 20150915
20150915174309
ACCESSION NUMBER: 0001619954-15-000032
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20150903
FILED AS OF DATE: 20150915
DATE AS OF CHANGE: 20150915
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Inovalon Holdings, Inc.
CENTRAL INDEX KEY: 0001619954
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMPUTER PROCESSING & DATA PREPARATION [7374]
IRS NUMBER: 471830316
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 4321 COLLINGTON ROAD
CITY: BOWIE
STATE: MD
ZIP: 20716
BUSINESS PHONE: 301-809-4000
MAIL ADDRESS:
STREET 1: 4321 COLLINGTON ROAD
CITY: BOWIE
STATE: MD
ZIP: 20716
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Rizzo Daniel L
CENTRAL INDEX KEY: 0001632874
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36841
FILM NUMBER: 151108522
MAIL ADDRESS:
STREET 1: C/O INOVALON HOLDINGS, INC.
STREET 2: 4321 COLLINGTON ROAD
CITY: BOWIE
STATE: MD
ZIP: 20716
4
1
edgar.xml
PRIMARY DOCUMENT
X0306
4
2015-09-03
0001619954
Inovalon Holdings, Inc.
INOV
0001632874
Rizzo Daniel L
4321 COLLINGTON ROAD
BOWIE
MD
20716
0
1
0
0
Chief Innovation Officer
Class A Common Stock
2015-09-03
4
C
0
360000
0
A
360000
D
Class A Common Stock
2015-09-03
4
C
0
144000
0
A
144000
I
By Trust
Class B Common Stock
2015-09-03
4
C
0
360000
0
D
Class A Common Stock
360000
3170400
D
Class B Common Stock
2015-09-03
4
C
0
144000
0
D
Class A Common Stock
144000
1231050
I
By Trust
Class B Common Stock
Class A Common Stock
458765
458765
I
By Trust
Shares owned by an irrevocable trust for the sole benefit of Mr. Rizzo's son.
The Class B Common Stock is convertible into the issuer's Class A Common Stock on a 1-for-1 basis (a) at the holder's option or (b) upon certain transfers of such shares, and has no expiration date.
The holder elected to convert the shares of Class B Common Stock into shares of Class A Common Stock on a 1-for-1 basis.
Shares owned by an irrevocable charitable trust, with an unrelated trustee, over which Mr. Rizzo maintains dispositive control.
/s/ Shauna L. Vernal, Attorney-in-Fact for Daniel L. Rizzo
2015-09-15