0001953718-23-000001.txt : 20230621 0001953718-23-000001.hdr.sgml : 20230621 20230621161033 ACCESSION NUMBER: 0001953718-23-000001 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230616 FILED AS OF DATE: 20230621 DATE AS OF CHANGE: 20230621 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Kantz Erik CENTRAL INDEX KEY: 0001953718 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39439 FILM NUMBER: 231029947 MAIL ADDRESS: STREET 1: C/O ATI HOLDINGS, LLC STREET 2: 790 REMINGTON BOULEVARD CITY: BOLINGBROOK STATE: IL ZIP: 60440 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: ATI Physical Therapy, Inc. CENTRAL INDEX KEY: 0001815849 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-NURSING & PERSONAL CARE FACILITIES [8050] 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 X0407 4 2023-06-16 0 0001815849 ATI Physical Therapy, Inc. ATIP 0001953718 Kantz Erik C/O ATI HOLDINGS, LLC 790 REMINGTON BOULEVARD BOLINGBROOK IL 60440 0 1 0 0 Chief Legal Officer 0 Class A Common Stock 2023-06-16 4 F 0 12 10.53 D 16365 D Stock Option (Right to Buy) 87 2022-03-07 4 A 0 1314 0 A 2023-03-07 2032-03-07 Class A Common Stock 1314 1314 D As of June 14, 2023, the issuer effected a reverse stock split of its common stock at a ratio of 1-or-50, resulting in every 50 shares owned by the reporting person to be combined into one share of common stock. This option was adjusted to reflect the reverse stock split that occurred on June 14, 2023. John Lines as Attorney-in-Fact for Reporting Person 2023-06-21