0000899243-17-018948.txt : 20170726
0000899243-17-018948.hdr.sgml : 20170726
20170726121355
ACCESSION NUMBER: 0000899243-17-018948
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20170726
FILED AS OF DATE: 20170726
DATE AS OF CHANGE: 20170726
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Adcock Scott
CENTRAL INDEX KEY: 0001710673
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38163
FILM NUMBER: 17982081
MAIL ADDRESS:
STREET 1: 500 EAST SHORE DR
STREET 2: SUITE 120
CITY: EAGLE
STATE: ID
ZIP: 83616
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: PetIQ, Inc.
CENTRAL INDEX KEY: 0001668673
STANDARD INDUSTRIAL CLASSIFICATION: WHOLESALE-DRUGS PROPRIETARIES & DRUGGISTS' SUNDRIES [5122]
IRS NUMBER: 000000000
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: PETIQ LLC
STREET 2: 500 E. SHORE DRIVE SUITE 120
CITY: EAGLE
STATE: ID
ZIP: 83616
BUSINESS PHONE: 208-939-8900
MAIL ADDRESS:
STREET 1: PETIQ LLC
STREET 2: 500 E. SHORE DRIVE SUITE 120
CITY: EAGLE
STATE: ID
ZIP: 83616
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2017-07-26
0
0001668673
PetIQ, Inc.
PETQ
0001710673
Adcock Scott
500 E. SHORE DRIVE, SUITE 120
EAGLE
ID
83616
1
1
0
0
President
Class B Common Stock
2017-07-26
4
D
0
66667
16.00
D
809574
I
See Footnote
Non-Qualified Stock Option (right to buy)
16.00
2017-07-26
4
A
0
205405
0.00
A
Class A Common Stock
205405
205405
D
The shares were repurchased by the Issuer.
Shares are held by Adcock Ventures, LLC ("Ventures"). Mr. Adcock is the manager of Ventures and exercises voting and investment control over all shares held by Ventures.
The options vest and become exercisable in four approximately equal installments on each of the first four anniversaries of July 20, 2017.
The options terminate on the tenth anniversary of July 20, 2017.
/s/ Robert Mooney, Attorney in Fact
2017-07-26