0001867148-24-000001.txt : 20240822 0001867148-24-000001.hdr.sgml : 20240822 20240822170251 ACCESSION NUMBER: 0001867148-24-000001 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20240820 FILED AS OF DATE: 20240822 DATE AS OF CHANGE: 20240822 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Burns Joanne CENTRAL INDEX KEY: 0001867148 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39439 FILM NUMBER: 241232703 MAIL ADDRESS: STREET 1: C/O ATI PHYSICAL THERAPY STREET 2: 790 REMINGTON BLVD. CITY: BOLINGBROOK STATE: IL ZIP: 60440-4909 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: ATI Physical Therapy, Inc. CENTRAL INDEX KEY: 0001815849 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-NURSING & PERSONAL CARE FACILITIES [8050] ORGANIZATION NAME: 08 Industrial Applications and Services IRS NUMBER: 851408039 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 790 REMINGTON BOULEVARD CITY: BOILINGBROOK STATE: IL ZIP: 60440 BUSINESS PHONE: 630-296-2223 MAIL ADDRESS: STREET 1: 790 REMINGTON BOULEVARD CITY: BOILINGBROOK STATE: IL ZIP: 60440 FORMER COMPANY: FORMER CONFORMED NAME: Fortress Value Acquisition Corp. II DATE OF NAME CHANGE: 20200622 4 1 primary_doc.xml PRIMARY DOCUMENT X0508 4 2024-08-20 0 0001815849 ATI Physical Therapy, Inc. ATIP 0001867148 Burns Joanne C/O ATI HOLDINGS, LLC 790 REMINGTON BLVD. BOLINGBROOK IL 60440-4909 1 0 0 0 0 Stock Option (Right to Buy) 10 2024-08-20 4 A 0 6255 0 A 2034-08-20 Class A Common Stock 6255 7885 D Stock Option (Right to Buy) 12.5 2024-08-20 4 A 0 6255 0 A 2034-08-20 Class A Common Stock 6255 14140 D Stock Option (Right to Buy) 25 2024-08-20 4 A 0 6255 0 A 2034-08-20 Class A Common Stock 6255 20395 D Stock Option (Right to Buy) 50 2024-08-20 4 A 0 12509 0 A 2034-08-20 Class A Common Stock 12509 32904 D Stock Option (Right to Buy) 171 2031-11-23 Class A Common Stock 560 560 D Stock Option (Right to Buy) 87 2032-03-07 Class A Common Stock 1070 1630 D One-third of the Stock Options vest on each of the following dates: April 1, 2025, April 1, 2026, and April 1, 2027, each subject to the Reporting Person's continued service through the applicable vesting date or application of certain vesting acceleration rights. This Stock Option was adjusted to reflect the reverse stock split that occurred on June 14, 2023. One-third of the Stock Options vest on each of the first three anniversaries of November 23, 2021, each subject to the Reporting Person's continued service through the applicable vesting date. This Stock Option was adjusted to reflect the reverse stock split that occurred on June 14, 2023. One-third of the Stock Options vest on each of the first three anniversaries of March 7, 2022, each subject to the Reporting Person's continued service through the applicable vesting date. /s/ Erik Kantz as Attorney-in-Fact for Reporting Person 2024-08-22