0001179110-17-004573.txt : 20170314
0001179110-17-004573.hdr.sgml : 20170314
20170314173129
ACCESSION NUMBER: 0001179110-17-004573
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20170313
FILED AS OF DATE: 20170314
DATE AS OF CHANGE: 20170314
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: 17689072
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
2017-03-13
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
Common Stock, par value $0.001 per share
2017-03-13
4
S
0
352622
36.00
D
1609494
D
Common Stock, par value $0.001 per share
2017-03-13
4
S
0
88156
36.00
D
402363
I
By family trust for son
Common Stock, par value $0.001 per share
2017-03-13
4
S
0
88156
36.00
D
402373
I
By family trust for daughter
Common Stock, par value $0.001 per share
2017-03-13
4
S
0
88156
36.00
D
402373
I
By family trust for daughter
Common Stock, par value $0.001 per share
1048096
I
By limited liability company
The shares were sold in a registered underwritten secondary offering pursuant to an underwriting agreement entered into on March 7, 2017.
Represents public offering price of $36.00 per share.
Held directly by a family irrevocable trust of which a son of the Reporting Person is the beneficiary, and of which the trustees are an institution and the Reporting Person's spouse. The Reporting Person disclaims beneficial ownership of these securities, and the filing of this report is not an admission that the Reporting Person is the beneficial owner of these securities for purposes of Section 16 or for any other purpose.
Held directly by a family irrevocable trust of which a daughter of the Reporting Person is the beneficiary, and of which the trustees are an institution and the Reporting Person's spouse. The Reporting Person disclaims beneficial ownership of these securities, and the filing of this report is not an admission that the Reporting Person is the beneficial owner of these securities for purposes of Section 16 or for any other purpose.
Held directly by a family irrevocable trust of which a daughter of the Reporting Person is the beneficiary, and of which the trustees are an institution and the Reporting Person's spouse. The Reporting Person disclaims beneficial ownership of these securities, and the filing of this report is not an admission that the Reporting Person is the beneficial owner of these securities for purposes of Section 16 or for any other purpose.
These shares are held by Milton Harbor View, LLC, of which the Reporting Person and her spouse are the sole managers and of which she is a member. The Reporting Person disclaims beneficial ownership of the reported securities except to the extent of her pecuniary interest therein.
/s/ Jonathan Olefson, attorney-in-fact
2017-03-14