0001593968-21-000379.txt : 20210208
0001593968-21-000379.hdr.sgml : 20210208
20210208182942
ACCESSION NUMBER: 0001593968-21-000379
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210131
FILED AS OF DATE: 20210208
DATE AS OF CHANGE: 20210208
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Kennedy Ronald
CENTRAL INDEX KEY: 0001710694
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38163
FILM NUMBER: 21603003
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: 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
2021-01-31
0001668673
PetIQ, Inc.
PETQ
0001710694
Kennedy Ronald
923 S. BRIDGE WAY PL
EAGLE
ID
83616-6885
true
false
false
false
Non-Employee Director
Class A Common Stock
2021-01-31
4
C
false
10000
0
A
181792
I
See Footnote
Class B common stock
2021-01-31
4
C
false
10000
D
Class A Common Stock
10000
119956
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 are held by Kennedy Family Investments, LLC. Mr. Kennedy is the manager of Kennedy Family Investments, LLC and exercises voting and investment control over all shares held by Kennedy Family Investments, LLC.
This Form 4 is being filed late due to inadvertent administrative error.
/s/ R. Michael Herrman, as attorney-in-fact
2021-02-08