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