0001209191-21-020960.txt : 20210316
0001209191-21-020960.hdr.sgml : 20210316
20210316173158
ACCESSION NUMBER: 0001209191-21-020960
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210315
FILED AS OF DATE: 20210316
DATE AS OF CHANGE: 20210316
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: 21747230
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
2021-03-15
0
0001728688
i3 Verticals, Inc.
IIIV
0001738212
HARVEY ROBERT BURTON
40 BURTON HILLS BLVD.
SUITE 415
NASHVILLE
TN
37215
1
0
0
0
Class A common stock, par value $0.0001 per share
2021-03-15
4
C
0
110000
A
110000
I
By CCSD II, L.P.
Class A common stock, par value $0.0001 per share
2021-03-15
4
C
0
76000
A
76000
I
By Claritas Capital Specialty Debt Fund, LP
Class A common stock, par value $0.0001 per share
2021-03-15
4
C
0
14000
A
14000
I
By CF i3 Corporation
Class A common stock, par value $0.0001 per share
2021-03-15
4
S
0
110000
32.83
D
0
I
By CCSD II, L.P.
Class A common stock, par value $0.0001 per share
2021-03-15
4
S
0
76000
32.83
D
0
I
By Claritas Capital Specialty Debt Fund, LP
Class A common stock, par value $0.0001 per share
2021-03-15
4
S
0
14000
32.83
D
0
I
By CF i3 Corporation
Class B common stock, par value $0.0001 per share
2021-03-15
4
J
0
110000
D
41910
I
By CCSD II, L.P.
Class B common stock, par value $0.0001 per share
2021-03-15
4
J
0
76000
D
28012
I
By Claritas Capital Specialty Debt Fund, LP
Class B common stock, par value $0.0001 per share
2021-03-15
4
J
0
14000
D
4687
I
By CF i3 Corporation
Class B common stock, par value $0.0001 per share
11716
D
Common Units
2021-03-15
4
C
0
110000
D
Class A common stock, par value $0.0001 per share
110000
41910
I
By CCSD II, L.P.
Common Units
2021-03-15
4
C
0
76000
D
Class A common stock, par value $0.0001 per share
76000
28012
I
By Claritas Capital Specialty Debt Fund, LP
Common Units
2021-03-15
4
C
0
14000
D
Class A common stock, par value $0.0001 per share
14000
4687
I
By CF i3 Corporation
Common Units
Class A common stock, par value $0.0001 per share
11716
11716
D
Represents shares of Class A common stock, par value $0.0001 per share ("Class A Common Stock") of i3 Verticals, Inc. (the "Issuer") that were obtained upon a redemption of an equal number of common units in i3 Verticals, LLC (the "Common Units").
Represents shares of Class A 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 A 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 A 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.
Pursuant to the Amended and Restated Certificate of Incorporation of 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 the Common Units for shares of Class A Common Stock of the Issuer.
Represents shares of Class B Common Stock held by CCSD. 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. 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. 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 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
2021-03-16