0001593968-20-000301.txt : 20200203 0001593968-20-000301.hdr.sgml : 20200203 20200203123732 ACCESSION NUMBER: 0001593968-20-000301 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20200131 FILED AS OF DATE: 20200203 DATE AS OF CHANGE: 20200203 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Santana Will CENTRAL INDEX KEY: 0001727824 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38163 FILM NUMBER: 20567787 MAIL ADDRESS: STREET 1: 500 E 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: 923 S. BRIDGEWAY PL. CITY: EAGLE STATE: ID ZIP: 83616 BUSINESS PHONE: 208-939-8900 MAIL ADDRESS: STREET 1: PETIQ LLC STREET 2: 923 S. BRIDGEWAY PL. CITY: EAGLE STATE: ID ZIP: 83616 4 1 primary_01.xml PRIMARY DOCUMENT X0306 4 2020-01-31 0001668673 PetIQ, Inc. PETQ 0001727824 Santana Will 923 BRIDGE WAY PL EAGLE ID 83616 true true false false Executive Vice President Class A Common Stock 2020-01-31 4 C false 52500 0 A 105000 I See Footnote Class B Common Stock 2020-01-31 4 C false 52500 0 D Class A Common Stock 52500 779333 I See footnote Represents the conversion of Class B Common Stock into Class A Common Stock held of record by the Reporting Person. Each share of Class B Common Stock is convertible into one share of Class A Common Stock at the option of the holder and has no expiration date. The shares of Common Stock are held by VIP Petcare Holdings, Inc. Mr. Santana holds 50% of the equity interests of VIP Petcare Holdings, Inc. /s/ R. Michael Herrman, as attorney-in-fact 2020-02-03