0001179110-18-011881.txt : 20181002 0001179110-18-011881.hdr.sgml : 20181002 20181002163104 ACCESSION NUMBER: 0001179110-18-011881 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20180928 FILED AS OF DATE: 20181002 DATE AS OF CHANGE: 20181002 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Clarke James Nathan CENTRAL INDEX KEY: 0001710881 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38163 FILM NUMBER: 181101713 MAIL ADDRESS: STREET 1: 500 EAST SHORE DRIVE 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 edgar.xml FORM 4 - X0306 4 2018-09-28 0 0001668673 PetIQ, Inc. PETQ 0001710881 Clarke James Nathan 923 S. BRIDGEWAY PL EAGLE ID 83616 1 0 0 0 Class A Common Stock 2018-09-28 4 C 0 166000 0 A 166000 I See Footnote Class A Common Stock 2018-10-01 4 S 0 166000 37.1475 D 0 I See Footnote Class B Common Stock 2018-09-28 4 C 0 166000 0 D Class A Common Stock 166000 1793680 I See Footnote Represents the exchange of Class B Common Stock into Class A Common Stock held of record by the reporting person. The converted shares are held by The JNC 101 Trust. Andrea Clarke, the wife of James Clarke, is the trustee of this trust and exercises voting and investment control over all shares held by the trust. Also includes 889,123 shares of Class B Common Stock held by the JNC 101 Trust, 239,916 shares of Class B Common Stock held by the James N. Clarke Irrevocable Trust, dated December 27, 2012, of which Mrs. Clarke is the trustee and 239,916 shares of Class B Common Stock held by the Andrea M. Clarke Irrevocable Trust, dated December 27, 2012, of which Mr. Clarke is the trustee. Represents shares of Class A Common Stock sold to the underwriters pursuant to an underwritten public offering that closed on October 1, 2018. The price per share received by the reporting person is equal to the public offering price of $39.00, less the underwriting discount. Each share of Class B Common Stock may be exchanged for one share of Class A Common Stock at the option of the holder and has no expiration date. Includes 353,703 shares of Class B Common Stock held by Labore et Honore LLC and 71,022 shares of Class B Common Stock held by Clarke Capital Partners LLC (collectively, the "Clarke Capital Entities"). Mr. Clarke is the manager of the Clarke Capital Entities and has voting and investment control over, and may be deemed the beneficial owner of, the shares of Class B Common Stock held by the Clarke Capital Entities. /s/ Robert Mooney, Attorney in Fact 2018-10-02