4//SEC Filing
Tabula Rasa HealthCare, Inc. 4
Accession 0001192482-16-000718
CIK 0001651561operating
Filed
Oct 4, 8:00 PM ET
Accepted
Oct 5, 4:18 PM ET
Size
21.6 KB
Accession
0001192482-16-000718
Insider Transaction Report
Form 4
ORIGINATE GROWTH FUND 1Q LP
10% Owner
Transactions
- Conversion
Common Stock
2016-10-04+1,043,510→ 1,126,670 total - Conversion
Common Stock
2016-10-04+119,055→ 1,914,078 total - Conversion
Series A-1 Preferred Stock
2016-10-04−1,296,605→ 0 total→ Common Stock (668,353 underlying) - Conversion
Common Stock
2016-10-04+668,353→ 1,795,023 total - Conversion
Series A Preferred Stock
2016-10-04−2,024,410→ 0 total→ Common Stock (1,043,510 underlying) - Conversion
Series B Preferred Stock
2016-10-04−230,968→ 0 total→ Common Stock (119,055 underlying)
Originate Growth GP, LLC
10% Owner
Transactions
- Conversion
Series A-1 Preferred Stock
2016-10-04−1,296,605→ 0 total→ Common Stock (668,353 underlying) - Conversion
Common Stock
2016-10-04+668,353→ 1,795,023 total - Conversion
Common Stock
2016-10-04+119,055→ 1,914,078 total - Conversion
Common Stock
2016-10-04+1,043,510→ 1,126,670 total - Conversion
Series A Preferred Stock
2016-10-04−2,024,410→ 0 total→ Common Stock (1,043,510 underlying) - Conversion
Series B Preferred Stock
2016-10-04−230,968→ 0 total→ Common Stock (119,055 underlying)
BRESSNER GLEN R
Director10% Owner
Transactions
- Conversion
Common Stock
2016-10-04+1,043,510→ 1,126,670 total - Conversion
Common Stock
2016-10-04+119,055→ 1,914,078 total - Conversion
Series A-1 Preferred Stock
2016-10-04−1,296,605→ 0 total→ Common Stock (668,353 underlying) - Conversion
Common Stock
2016-10-04+668,353→ 1,795,023 total - Conversion
Series A Preferred Stock
2016-10-04−2,024,410→ 0 total→ Common Stock (1,043,510 underlying) - Conversion
Series B Preferred Stock
2016-10-04−230,968→ 0 total→ Common Stock (119,055 underlying)
Arnson Eric R
10% Owner
Transactions
- Conversion
Common Stock
2016-10-04+1,043,510→ 1,126,670 total - Conversion
Series A Preferred Stock
2016-10-04−2,024,410→ 0 total→ Common Stock (1,043,510 underlying) - Conversion
Series B Preferred Stock
2016-10-04−230,968→ 0 total→ Common Stock (119,055 underlying) - Conversion
Common Stock
2016-10-04+668,353→ 1,795,023 total - Conversion
Common Stock
2016-10-04+119,055→ 1,914,078 total - Conversion
Series A-1 Preferred Stock
2016-10-04−1,296,605→ 0 total→ Common Stock (668,353 underlying)
GAUSLING MICHAEL J
10% Owner
Transactions
- Conversion
Series A Preferred Stock
2016-10-04−2,024,410→ 0 total→ Common Stock (1,043,510 underlying) - Conversion
Series A-1 Preferred Stock
2016-10-04−1,296,605→ 0 total→ Common Stock (668,353 underlying) - Conversion
Series B Preferred Stock
2016-10-04−230,968→ 0 total→ Common Stock (119,055 underlying) - Conversion
Common Stock
2016-10-04+1,043,510→ 1,126,670 total - Conversion
Common Stock
2016-10-04+668,353→ 1,795,023 total - Conversion
Common Stock
2016-10-04+119,055→ 1,914,078 total
Footnotes (3)
- [F1]Originate Growth Fund #1Q, L.P. ("Originate #1Q") was the record holder of 2,024,410 shares of Series A Preferred Stock, which automatically converted into 1,043,510 shares of common stock upon the closing of the Issuer's initial public offering. Originate #1Q was the record holder of 1,296,605 shares of Series A-1 Preferred Stock, which automatically converted into 668,353 shares of common stock upon the closing of the Issuer's initial public offering. Originate #1Q was the record holder of 230,968 shares of Series B Preferred Stock, which automatically converted into 119,055 shares of common stock upon the closing of the Issuer's initial public offering.
- [F2]This report is filed jointly by Originate #1Q, Originate Growth GP, LLC ("Originate GP"), Glen Bressner ("Bressner"), Eric Arnson ("Arnson"), and Michael Gausling ("Gausling"). The shares are held by Originate #1Q. The general partner of Originate #1Q is Originate GP, a limited liability company. The members of Originate GP are Bressner, Arnson, and Gausling. The members of Originate GP share voting and dispositive power over the shares held by Originate #1Q. Each of these individuals disclaims beneficial ownership of such shares, except to the extent of his pecuniary interest.
- [F3]All series of Preferred Stock automatically converted into Tabula Rasa HealthCare, Inc. (the "Issuer") common stock immediately prior to the closing of the initial public offering and have no expiration date.
Documents
Issuer
Tabula Rasa HealthCare, Inc.
CIK 0001651561
Entity typeoperating
IncorporatedDE
Related Parties
1- filerCIK 0001651561
Filing Metadata
- Form type
- 4
- Filed
- Oct 4, 8:00 PM ET
- Accepted
- Oct 5, 4:18 PM ET
- Size
- 21.6 KB