0001140361-16-068648.txt : 20160603 0001140361-16-068648.hdr.sgml : 20160603 20160603215254 ACCESSION NUMBER: 0001140361-16-068648 CONFORMED SUBMISSION TYPE: 3/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20160525 FILED AS OF DATE: 20160603 DATE AS OF CHANGE: 20160603 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 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Present Douglas CENTRAL INDEX KEY: 0001673014 FILING VALUES: FORM TYPE: 3/A SEC ACT: 1934 Act SEC FILE NUMBER: 001-37787 FILM NUMBER: 161697356 MAIL ADDRESS: STREET 1: C/O COTIVITI HOLDINGS, INC. STREET 2: 115 PERIMETER CENTER PLACE, SUITE 700 CITY: ATLANTA STATE: GA ZIP: 30346 3/A 1 doc1.xml FORM 3/A X0206 3/A 2016-05-25 2016-05-25 0 0001657197 Cotiviti Holdings, Inc. COTV 0001673014 Present Douglas C/O COTIVITI HOLDINGS, INC. 115 PERIMETER CENTER PLACE, SUITE 700 ATLANTA GA 30346 1 0 0 0 Options (right to buy) 6.26 2023-11-01 Common Stock, par value $0.001 per share 61580 D Options (right to buy) 6.26 2023-11-01 Common Stock, par value $0.001 per share 11895 D 52,658 of these options have vested and are immediately exercisable. The remaining 8,922 of these options vest and become exercisable in equal annual installments of 33 1/3% of the shares over a three-year period on each anniversary of November 01, 2015, subject to the Reporting Person's continued service through each applicable vesting date. These options ("Performance Awards") vest based on upon the weighted average price of the Issuer's common stock for any fiscal quarter exceeding a value that shall be calculated by the Issuer at the end of each such fiscal quarter in accordance with Stock Option Award Agreement pursuant to which such Performance Awards were granted, subject to the Reporting Person's continued service through each applicable vesting date. All, or a portion of, the Performance Awards may vest as early as September 30, 2016. Options that the Reporting Person forfeited in November 2014 were incorrectly included in the Reporting Person's original Form 3. In connection with such forfeiture, the vesting schedule of certain of the Reporting Person's options was accelerated, which such acceleration was not reported in the Reporting Person's original Form 3. /s/ Jonathan Olefson, attorney-in-fact 2016-06-03