0001209191-15-050572.txt : 20150605
0001209191-15-050572.hdr.sgml : 20150605
20150605161153
ACCESSION NUMBER: 0001209191-15-050572
CONFORMED SUBMISSION TYPE: 3
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20150605
FILED AS OF DATE: 20150605
DATE AS OF CHANGE: 20150605
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Evolent Health, Inc.
CENTRAL INDEX KEY: 0001628908
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MANAGEMENT SERVICES [8741]
IRS NUMBER: 453084136
FISCAL YEAR END: 1214
BUSINESS ADDRESS:
STREET 1: 800 NORTH GLEBE RD, SUITE 500
CITY: ARLINGTON
STATE: VA
ZIP: 22203
BUSINESS PHONE: 571-389-6000
MAIL ADDRESS:
STREET 1: 800 NORTH GLEBE RD, SUITE 500
CITY: ARLINGTON
STATE: VA
ZIP: 22203
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Thornton Dave
CENTRAL INDEX KEY: 0001642789
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37415
FILM NUMBER: 15916088
MAIL ADDRESS:
STREET 1: 8800 N. GLEBE ROAD, SUITE 500
CITY: ARLINGTON
STATE: VA
ZIP: 22203
3
1
doc3.xml
FORM 3 SUBMISSION
X0206
3
2015-06-05
0
0001628908
Evolent Health, Inc.
EVH
0001642789
Thornton Dave
C/O EVOLENT HEALTH, INC.
800 N. GLEBE ROAD, SUITE 500
ARLINGTON
VA
22203
0
1
0
0
Chief Talent Officer
Class A Common Stock
99000
D
Non-Qualified Stock Options
3.84
2024-04-01
Class A Common Stock
29700
D
Non-Qualified Stock Options
6.87
2025-02-01
Class A Common Stock
40000
D
Represents shares of restricted stock granted to Mr. Thornton pursuant to the Evolent Health, Inc. 2011 Equity Incentive Plan, which will automatically vest in connection with the registrant's initial public offering.
Securities vest at a rate of 25% annually beginning December 15, 2014.
Securities vest at a rate of 50% on February 1, 2018 and 50% on February 1, 2019.
/s/ David Thornton
2015-06-05