0001593968-21-001323.txt : 20210514 0001593968-21-001323.hdr.sgml : 20210514 20210514182306 ACCESSION NUMBER: 0001593968-21-001323 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210512 FILED AS OF DATE: 20210514 DATE AS OF CHANGE: 20210514 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: 21926662 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: 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 2021-05-12 0001668673 PetIQ, Inc. PETQ 0001710861 Christensen McCord 923 S. BRIDGEWAY PLACE EAGLE ID 83616 true true false false Chief Executive Officer Class A Common Stock 2021-05-12 4 C false 100000 0 A 107015 D Class B Common Stock 2021-05-12 4 C false 100000 D Class A Common Stock 100000 114027 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 Class B Common Stock are held by Christensen Ventures ("Ventures"). Mr. Christensen is the manager of Ventures and exercises voting and investment control over all shares held by Ventures. /s/ R. Michael Herrman, as attorney-in-fact 2021-05-14