0001179110-19-000307.txt : 20190103
0001179110-19-000307.hdr.sgml : 20190103
20190103173214
ACCESSION NUMBER: 0001179110-19-000307
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20181231
FILED AS OF DATE: 20190103
DATE AS OF CHANGE: 20190103
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Christensen McCord
CENTRAL INDEX KEY: 0001710861
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38163
FILM NUMBER: 19507201
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
2018-12-31
0
0001668673
PetIQ, Inc.
PETQ
0001710861
Christensen McCord
923 S. BRIDGEWAY PLACE
EAGLE
ID
83616
1
1
0
0
Chief Executive Officer
Class A Common Stock
2018-12-31
4
C
0
20000
0
A
20000
I
See Footnote
Class B Common Stock
2018-12-31
4
C
0
20000
0
D
Class A Common Stock
20000
428055
I
See Footnote
Represents the exchange of Class B Common Stock into Class A Common Stock held of record by the reporting person.
The shares are held by Christensen Ventures, LLC ("Ventures"). Mr. Christensen is the manager of Ventures and exercises voting and investment control over all shares held by Ventures.
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.
/s/ Robert Mooney, Attorney in Fact
2019-01-03