0001179110-17-008124.txt : 20170526 0001179110-17-008124.hdr.sgml : 20170526 20170526164135 ACCESSION NUMBER: 0001179110-17-008124 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170525 FILED AS OF DATE: 20170526 DATE AS OF CHANGE: 20170526 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: Beaulieu David CENTRAL INDEX KEY: 0001673104 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37787 FILM NUMBER: 17874556 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 2017-05-25 0 0001657197 Cotiviti Holdings, Inc. COTV 0001673104 Beaulieu David C/O COTIVITI HOLDINGS, INC. 115 PERIMETER CENTER PLACE, SUITE 700 ATLANTA GA 30346 0 1 0 0 SVP and COO Common Stock, par value $0.001 per share 2017-05-25 4 M 0 477 A 38297 D Common Stock, par value $0.001 per share 2017-05-25 4 F 0 164 39.39 D 38133 D Restricted Stock Units 2017-05-25 4 M 0 477 0 D Common Stock, par value $0.001 per share 477 1429 D Restricted Stock Units convert into Common Stock on a one-for-one basis. On May 25, 2016, the Reporting Person was granted 1,906 Restricted Stock Units, vesting in equal annual installments of 25% over a 4-year period on each anniversary date of the date of the grant, subject to the Reporting Person's continued service through each applicable vesting date. /s/ Jonathan Olefson, attorney-in-fact 2017-05-26