0001179110-16-029267.txt : 20160902 0001179110-16-029267.hdr.sgml : 20160902 20160902162850 ACCESSION NUMBER: 0001179110-16-029267 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20160901 FILED AS OF DATE: 20160902 DATE AS OF CHANGE: 20160902 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: Alexander Elizabeth Connolly CENTRAL INDEX KEY: 0001673364 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37787 FILM NUMBER: 161868990 MAIL ADDRESS: STREET 1: C/O COTIVITI HOLDINGS, INC. STREET 2: 115 PERIMETER CENTER PLACE, SUITE 700 CITY: ATLANTA STATE: GA ZIP: 30346 4 1 edgar.xml FORM 4 - X0306 4 2016-09-01 0 0001657197 Cotiviti Holdings, Inc. COTV 0001673364 Alexander Elizabeth Connolly C/O COTIVITI HOLDINGS, INC. 115 PERIMETER CENTER PLACE, SUITE 700 ATLANTA GA 30346 1 0 0 0 Restricted Stock Units 2016-09-01 4 A 0 4919 0 A Common Stock, par value $0.001 per share 4919 4919 D Each Restricted Stock Unit represents the right to receive, at settlement, one (1) share of common stock, par value $0.001 per share. The Restricted Stock Units vest on the date of Cotiviti Holdings, Inc.'s first annual meeting following the date of grant, September 1, 2016, subject to the Reporting Person's continued service through the vesting date. /s/ Jonathan Olefson, attorney-in-fact 2016-09-02