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