0001179110-21-010052.txt : 20211110 0001179110-21-010052.hdr.sgml : 20211110 20211110171555 ACCESSION NUMBER: 0001179110-21-010052 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211109 FILED AS OF DATE: 20211110 DATE AS OF CHANGE: 20211110 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: ORTENZIO ROBERT A CENTRAL INDEX KEY: 0000918697 STATE OF INCORPORATION: PA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34465 FILM NUMBER: 211397818 MAIL ADDRESS: STREET 1: 4718 OLD GETTYSBURG RD STREET 2: POST OFFICE BOX 2034 CITY: MECHANICSBURG STATE: PA ZIP: 30309 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: SELECT MEDICAL HOLDINGS CORP CENTRAL INDEX KEY: 0001320414 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-HOSPITALS [8060] IRS NUMBER: 000000000 FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: C/O SELECT MEDICAL CORP STREET 2: 4714 GETTYSBURG RD CITY: MECHANICSBURG STATE: PA ZIP: 17055 BUSINESS PHONE: 717-972-1100 MAIL ADDRESS: STREET 1: C/O SELECT MEDICAL CORP STREET 2: 4714 GETTYSBURG RD CITY: MECHANICSBURG STATE: PA ZIP: 17055 4 1 edgar.xml FORM 4 - X0306 4 2021-11-09 0 0001320414 SELECT MEDICAL HOLDINGS CORP SEM 0000918697 ORTENZIO ROBERT A C/O SELECT MEDICAL HOLDINGS CORPORATION 4714 GETTYSBURG ROAD MECHANICSBURG PA 17055 1 1 0 0 Exec. Chairman and Co-Founder Common Stock 2021-11-09 4 G 0 235211 0 A 5450174 D Common Stock 1529000 I By the Robert A. Ortenzio Descendants Trust Common Stock 1445195 I By the Rocco A. Ortenzio Separate Non-Exempt Descendants Trust Common Stock 3804805 I By the Rocco A. Ortenzio Separate Exempt Descendants Trust Common Stock 0 I By the Robert A. Ortenzio October 2019 GRAT Common Stock 652092 I By the Robert A. Ortenzio July 2020 GRAT Common Stock 274945 I By the Rocco A. Ortenzio 2014 Trust for Robert A. Ortenzio Common Stock 141868 I By the Robert A. Ortenzio 2014 Trust for Bryan A. Ortenzio Common Stock 141868 I By the Robert A. Ortenzio 2014 Trust for Kevin M. Ortenzio Common Stock 141867 I By the Robert A. Ortenzio 2014 Trust for Madeline G. Ortenzio 235,211 shares were previously owned by, and were contributed by, The Robert A. Ortenzio October 2019 GRAT to Robert Ortenzio. The reporting person beneficially owns the reported securities indirectly, but disclaims beneficial ownership of the reported securities except to the extent of his pecuniary interest therein. 87,315 shares were previously owned by, and were contributed by, The Robert A. Ortenzio October 2019 GRAT to The Robert A. Ortenzio 2014 Trust FBO Bryan A. Ortenzio. 87,315 shares were previously owned by, and were contributed by, The Robert A. Ortenzio October 2019 GRAT to The Robert A. Ortenzio 2014 Trust FBO Kevin M. Ortenzio. 87,315 shares were previously owned by, and were contributed by, The Robert A. Ortenzio October 2019 GRAT to The Robert A. Ortenzio 2014 Trust FBO Madeline G. Ortenzio. 218,276 shares were previously owned by, and were contributed by, The Rocco A. Ortenzio October 2019 GRAT to The Rocco A. Ortenzio 2014 Trust FBO Robert A. Ortenzio. /s/ Michael E. Tarvin, as attorney-in-fact 2021-11-10