0001209191-14-066393.txt : 20141104 0001209191-14-066393.hdr.sgml : 20141104 20141104190639 ACCESSION NUMBER: 0001209191-14-066393 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20141031 FILED AS OF DATE: 20141104 DATE AS OF CHANGE: 20141104 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Halyard Health, Inc. CENTRAL INDEX KEY: 0001606498 STANDARD INDUSTRIAL CLASSIFICATION: ORTHOPEDIC, PROSTHETIC & SURGICAL APPLIANCES & SUPPLIES [3842] IRS NUMBER: 464987888 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: P.O. BOX 619100 CITY: ALPHARETTA STATE: GA ZIP: 30004 BUSINESS PHONE: 678-425-9273 MAIL ADDRESS: STREET 1: P.O. BOX 619100 CITY: ALPHARETTA STATE: GA ZIP: 30004 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: KIMBERLY CLARK CORP CENTRAL INDEX KEY: 0000055785 STANDARD INDUSTRIAL CLASSIFICATION: CONVERTED PAPER & PAPERBOARD PRODS (NO CONTAINERS/BOXES) [2670] STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36440 FILM NUMBER: 141194599 BUSINESS ADDRESS: STREET 1: 351 PHELPS DRIVE CITY: IRVING STATE: TX ZIP: 75038 BUSINESS PHONE: 9722811200 MAIL ADDRESS: STREET 1: P O BOX 619100 STREET 2: DFW AIRPORT STATION CITY: DALLAS STATE: TX ZIP: 75261-9100 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2014-10-31 1 0001606498 Halyard Health, Inc. HYH 0000055785 KIMBERLY CLARK CORP P.O. BOX 619100 DALLAS TX 75261-9100 0 0 1 0 Common Stock, $0.01 par value 2014-10-31 4 J 0 48001000 D 0 D On October 31, 2014, Kimberly-Clark Corporation ("Kimberly-Clark") distributed all of the outstanding shares of common stock of Halyard Health, Inc. ("Halyard") to its stockholders in a previously announced pro rata distribution. Prior to the distribution, Halyard issued 48,000,000 shares of common stock to Kimberly-Clark in connection with the contribution of Kimberly-Clarks's health care business to Halyard. Pursuant to a distribution agreement between Kimberly-Clark and Halyard, 46,535,951 shares of Halyard common stock were distributed to Kimberly-Clark stockholders and the remaining shares of Halyard common sock were cancelled by the distribution agent. Additional information about this transaction can be found in Halyard's Registration Statement on Form 10, as amended. /s/ Jeffrey S. McFall, Associate General Counsel and Assistant Secretary 2014-10-31