0001415889-22-002773.txt : 20220308
0001415889-22-002773.hdr.sgml : 20220308
20220308200236
ACCESSION NUMBER: 0001415889-22-002773
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20220306
FILED AS OF DATE: 20220308
DATE AS OF CHANGE: 20220308
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Christensen Scott A
CENTRAL INDEX KEY: 0001756254
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-40361
FILM NUMBER: 22723504
MAIL ADDRESS:
STREET 1: C/O UNIVERSAL HOSPITAL SERVICES, INC.
STREET 2: 6625 WEST 78TH ST, SUITE 300
CITY: MINNEAPOLIS
STATE: MN
ZIP: 55439
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: AGILITI, INC. \DE
CENTRAL INDEX KEY: 0001749704
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MISCELLANEOUS EQUIPMENT RENTAL & LEASING [7350]
IRS NUMBER: 000000000
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 6625 WEST 78TH STREET, SUITE 300
CITY: MINNEAPOLIS
STATE: MN
ZIP: 55439
BUSINESS PHONE: 617-227-1050
MAIL ADDRESS:
STREET 1: 6625 WEST 78TH STREET, SUITE 300
CITY: MINNEAPOLIS
STATE: MN
ZIP: 55439
4
1
form4-03082022_050325.xml
X0306
4
2022-03-06
0001749704
AGILITI, INC. \DE
AGTI
0001756254
Christensen Scott A
C/O AGILITI, INC.
6625 WEST 78TH STREET, SUITE 300
MINNEAPOLIS
MN
55439
false
true
false
false
SVP, CONTROLLER & CAO
Common Stock, $0.0001 par value
2022-03-06
4
A
0
4703
0
A
55122
D
Common Stock, $0.0001 par value
2022-03-06
4
F
0
385
18.07
D
54737
D
The reported securities represent shares of Common Stock underlying performance restricted stock units ("PRSUs") granted to the reporting person on March 6, 2019 and March 6, 2020, which PRSUs vested on March 6, 2022 and will settle in Common Stock upon the earliest to occur of a Change in Control (as defined in the
applicable award agreements) and the first (1st) anniversary of the issuer's initial public offering (pursuant to the applicable award agreements).
/s/ Lee M. Neumann, by power of attorney
2022-03-08