0000950103-22-002875.txt : 20220218
0000950103-22-002875.hdr.sgml : 20220218
20220218181153
ACCESSION NUMBER: 0000950103-22-002875
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20220216
FILED AS OF DATE: 20220218
DATE AS OF CHANGE: 20220218
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Peterson Kyle B.
CENTRAL INDEX KEY: 0001842579
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-40028
FILM NUMBER: 22654304
MAIL ADDRESS:
STREET 1: 800 CONNECTICUT AVENUE
CITY: NORWALK
STATE: CT
ZIP: 06854
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Signify Health, Inc.
CENTRAL INDEX KEY: 0001828182
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-HOME HEALTH CARE SERVICES [8082]
IRS NUMBER: 000000000
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 800 CONNECTICUT AVENUE
CITY: NORWALK
STATE: CT
ZIP: 06854
BUSINESS PHONE: (203) 541-4600
MAIL ADDRESS:
STREET 1: 800 CONNECTICUT AVENUE
CITY: NORWALK
STATE: CT
ZIP: 06854
4
1
dp167455_4-peterson.xml
FORM 4
X0306
4
2022-02-16
0
0001828182
Signify Health, Inc.
SGFY
0001842579
Peterson Kyle B.
C/O SIGNIFY HEALTH, INC.
800 CONNECTICUT AVENUE
NORWALK
CT
06854
1
0
0
0
Class A Common Stock
2022-02-16
4
J
0
7916
0
D
0
D
Represents the assignment of shares of Class A Common Stock acquired upon vesting of restricted stock units to New Mountain Capital, LLC ("New Mountain") pursuant to an assignment agreement between the reporting person and New Mountain. The reporting person disclaims beneficial ownership of the restricted stock units and the underlying shares of Class A Common Stock.
/s/ Adam McAnaney as Attorney-in-Fact for Kyle B. Peterson
2022-02-18