0001387131-20-000302.txt : 20200116
0001387131-20-000302.hdr.sgml : 20200116
20200116160435
ACCESSION NUMBER: 0001387131-20-000302
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20200114
FILED AS OF DATE: 20200116
DATE AS OF CHANGE: 20200116
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Peterson Karl Mr.
CENTRAL INDEX KEY: 0001425873
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38136
FILM NUMBER: 20530965
MAIL ADDRESS:
STREET 1: 301 COMMERCE STREET
STREET 2: SUITE 3300
CITY: FORT WORTH
STATE: TX
ZIP: 76102
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Accel Entertainment, Inc.
CENTRAL INDEX KEY: 0001698991
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-AMUSEMENT & RECREATION SERVICES [7900]
IRS NUMBER: 981350261
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 140 TOWER DRIVE
CITY: BURR RIDGE
STATE: IL
ZIP: 60527
BUSINESS PHONE: 630-972-2235
MAIL ADDRESS:
STREET 1: 140 TOWER DRIVE
CITY: BURR RIDGE
STATE: IL
ZIP: 60527
FORMER COMPANY:
FORMER CONFORMED NAME: TPG Pace Holdings Corp.
DATE OF NAME CHANGE: 20170224
4
1
acel-form4_011420.xml
OWNERSHIP DOCUMENT
X0306
4
2020-01-14
0
0001698991
Accel Entertainment, Inc.
ACEL
0001425873
Peterson Karl Mr.
C/O TPG GLOBAL, LLC,
301 COMMERCE STREET, SUITE 3300
FORT WORTH
TX
76102
1
0
0
0
Class A-1 Common Stock
2020-01-14
4
C
0
207200
A
2775646
I
See Explanation of Responses
Class A-2 Common Stock
2020-01-14
4
C
0
207200
D
Class A-1 Common Stock
207200
414400
I
See Explanation of Responses
On January 14, 2020, pursuant to the Amended and Restated Certificate of Incorporation of Accel Entertainment, Inc. (the "Issuer") and the Restricted Stock Agreement, dated as of November 20, 2019, the first tranche of shares of Class A-2 Common Stock ("Class A-2 Common Stock") of the Issuer held by Mr. Karl Peterson converted into an equal number of shares of Class A-1 Common Stock ("Class A-1 Common Stock") of the Issuer. The shares of Class A-2 Common Stock are convertible into shares of Class A-1 Common Stock on a one-for-one basis, subject to adjustment, in three separate tranches upon the satisfaction of certain triggers based on the Issuer's financial performance, or upon certain other events, subject to certain exceptions as set forth in the Restricted Stock Agreement.
Held through personal vehicles.
(3) Michael LaGatta is signing on behalf of Mr. Peterson pursuant to the authorization and designation letter dated March 14, 2017, which was previously filed with the Securities and Exchange Commission.
/s/ Michael LaGatta on behalf of Karl Peterson(3)
2020-01-16