0000904454-17-000668.txt : 20171115 0000904454-17-000668.hdr.sgml : 20171115 20171115150220 ACCESSION NUMBER: 0000904454-17-000668 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170907 FILED AS OF DATE: 20171115 DATE AS OF CHANGE: 20171115 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Doyle Michael Thomas CENTRAL INDEX KEY: 0001650454 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37576 FILM NUMBER: 171205053 MAIL ADDRESS: STREET 1: 40 BURTON HILLS BOULEVARD SUITE 500 CITY: NASHVILLE STATE: TN ZIP: 37215 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Surgery Partners, Inc. CENTRAL INDEX KEY: 0001638833 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-GENERAL MEDICAL & SURGICAL HOSPITALS, NEC [8062] IRS NUMBER: 473620923 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 40 BURTON HILLS BLVD. CITY: NASHVILLE STATE: TN ZIP: 37215 BUSINESS PHONE: 615-234-5900 MAIL ADDRESS: STREET 1: 40 BURTON HILLS BLVD. CITY: NASHVILLE STATE: TN ZIP: 37215 4 1 edgar.xml PRIMARY DOCUMENT X0306 4 2017-09-07 0001638833 Surgery Partners, Inc. SGRY 0001650454 Doyle Michael Thomas C/O SURGERY PARTNERS, INC., 40 BURTON HILLS BOULEVARD, SUITE 500 NASHVILLE TN 37215 1 0 0 0 Common Stock 2017-09-07 4 F 0 39286 10.55 D 2987537 D Common Stock 134937 I By trusts Shares withheld by the Issuer to satisfy the Reporting Person's tax withholding obligations in connection with the vesting of all outstanding incentive equity awards previously granted to the Reporting Person upon his resignation as Chief Executive Officer of the Issuer on September 7, 2017. Shares held in equal amounts in three trusts for the benefit of the Reporting Person's children, of which his wife is trustee. The Reporting Person disclaims beneficial ownership of such shares. /s/ Michael T. Doyle 2017-11-15