0001209191-19-036337.txt : 20190612 0001209191-19-036337.hdr.sgml : 20190612 20190612143940 ACCESSION NUMBER: 0001209191-19-036337 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190610 FILED AS OF DATE: 20190612 DATE AS OF CHANGE: 20190612 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: HARVEY ROBERT BURTON CENTRAL INDEX KEY: 0001738212 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38532 FILM NUMBER: 19893450 MAIL ADDRESS: STREET 1: 40 BURTON HILLS BOULEVARD, SUITE 415 CITY: NASHVILLE STATE: TN ZIP: 37215 FORMER NAME: FORMER CONFORMED NAME: BURTON ROBERT HARVEY DATE OF NAME CHANGE: 20180420 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: i3 Verticals, Inc. CENTRAL INDEX KEY: 0001728688 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-BUSINESS SERVICES, NEC [7389] IRS NUMBER: 824052852 STATE OF INCORPORATION: DE FISCAL YEAR END: 0930 BUSINESS ADDRESS: STREET 1: 40 BURTON HILLS BLVD. STREET 2: SUITE 415 CITY: NASHVILLE STATE: TN ZIP: 37215 BUSINESS PHONE: 800-203-7981 MAIL ADDRESS: STREET 1: 40 BURTON HILLS BLVD. STREET 2: SUITE 415 CITY: NASHVILLE STATE: TN ZIP: 37215 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2019-06-10 0 0001728688 i3 Verticals, Inc. IIIV 0001738212 HARVEY ROBERT BURTON 40 BURTON HILLS BLVD. SUITE 415 NASHVILLE TN 37215 1 0 0 0 Class B common stock, par value $0.0001 per share 2019-06-10 4 D 0 573341 D 378513 I By CCSD II, L.P. Class B common stock, par value $0.0001 per share 2019-06-10 4 D 0 392556 D 259163 I By Claritas Capital Specialty Debt Fund, LP Class B common stock, par value $0.0001 per share 2019-06-10 4 D 0 70528 D 46562 I By CF i3 Corporation Class B common stock, par value $0.0001 per share 11716 D Common Units 2019-06-10 4 D 0 573341 21.61 D Class A common stock, par value $0.0001 per share 573341 378513 I By CCSD II, L.P. Common Units 2019-06-10 4 D 0 392556 21.61 D Class A common stock, par value $0.0001 per share 392556 259163 I By Claritas Capital Specialty Debt Fund, LP Common Units 2019-06-10 4 D 0 70528 21.61 D Class A common stock, par value $0.0001 per share 70528 46562 I By CF i3 Corporation Common Units Class A common stock, par value $0.0001 per share 11716 11716 D Pursuant to the Amended and Restated Certificate of Incorporation of i3 Verticals, Inc. (the "Issuer"), the shares of the Issuer's Class B common stock, par value $0.0001 per share ("Class B Common Stock") are cancelled for no consideration on a one-to-one basis upon redemption of common units in i3 Verticals, LLC (the "Common Units") for shares of Class A common stock, par value $0.0001 per share ("Class A Common Stock") of the Issuer. Represents shares of Class B Common Stock held by CCSD II, L.P. ("CCSD"), of which the Reporting Person serves as a voting member of the investment committee. The Reporting Person disclaims beneficial ownership of such shares, except to the extent of his pecuniary interest therein. Represents shares of Class B Common Stock held by Claritas Capital Specialty Debt Fund, L.P. ("Claritas"), of which the Reporting Person serves as a voting member of the investment committee. The Reporting Person disclaims beneficial ownership of such shares, except to the extent of his pecuniary interest therein. Represents shares of Class B Common Stock held by CF i3 Corporation ("CF"), of which the Reporting Person serves as an officer. The Reporting Person disclaims beneficial ownership of such shares, except to the extent of his pecuniary interest therein. The Common Units may be redeemed by the holder at any time for an equal number of shares of Class A Common Stock or, at the election of i3 Verticals, LLC, cash equal to the volume-weighted average market price of such shares. Upon the redemption of a Common Unit for Class A Common Stock, any corresponding share of Class B Common Stock will be cancelled. The Common Units have no expiration date. Represents the sale of Common Units to the Issuer pursuant to the Common Unit Purchase Agreement entered into in connection with the Issuer's offering of Class A common stock which closed on June 10, 2019, pursuant to the Limited Liability Company Agreement of i3 Verticals, LLC and in accordance with the Registration Rights Agreement among the Issuer and the signatories thereto. Represents Common Units held by CCSD. The Reporting Person disclaims beneficial ownership of such shares, except to the extent of his pecuniary interest therein. Represents Common Units held by Claritas. The Reporting Person disclaims beneficial ownership of such shares, except to the extent of his pecuniary interest therein. Represents Common Units held by CF. The Reporting Person disclaims beneficial ownership of such shares, except to the extent of his pecuniary interest therein. /s/ Paul Maple, Attorney-in-Fact for Robert Burton Harvey 2019-06-12