4//SEC Filing
Tabula Rasa HealthCare, Inc. 4
Accession 0001192482-16-000722
CIK 0001651561operating
Filed
Oct 4, 8:00 PM ET
Accepted
Oct 5, 4:24 PM ET
Size
18.4 KB
Accession
0001192482-16-000722
Insider Transaction Report
Form 4
GAUSLING MICHAEL J
10% Owner
Transactions
- Conversion
Common Stock
2016-10-04+1,516,070→ 1,636,888 total(indirect: By Originate Growth Fund #1A, L.P. and Originate Growth Fund #1Q, L.P.) - Conversion
Series A-1 Preferred Stock
2016-10-04−1,883,763→ 0 total(indirect: By Originate Growth Fund #1A, L.P. and Originate Growth Fund #1Q, L.P.)→ Common Stock (971,012 underlying) - Conversion
Series B Preferred Stock
2016-10-04−335,557→ 0 total(indirect: By Originate Growth Fund #1A, L.P. and Originate Growth Fund #1Q, L.P.)→ Common Stock (172,967 underlying) - Purchase
Common Stock
2016-10-04$12.00/sh+8,000$96,000→ 2,788,867 total - Conversion
Series A Preferred Stock
2016-10-04−2,941,176→ 0 total(indirect: By Originate Growth Fund #1A, L.P. and Originate Growth Fund #1Q, L.P.)→ Common Stock (1,516,070 underlying) - Conversion
Common Stock
2016-10-04+971,012→ 2,607,900 total(indirect: By Originate Growth Fund #1A, L.P. and Originate Growth Fund #1Q, L.P.) - Conversion
Common Stock
2016-10-04+172,967→ 2,780,867 total(indirect: By Originate Growth Fund #1A, L.P. and Originate Growth Fund #1Q, L.P.)
Footnotes (4)
- [F1]The shares consist of (a) 472,560 shares of common stock issued upon the conversion of 916,766 shares of Series A preferred stock held by Originate Growth Fund #1A, L.P., ("Originate #1A"), (b) 1,043,510 shares of common stock issued upon the conversion of 2,024,410 shares of Series A preferred stock held by Originate Growth Fund #1Q, L.P., ("Originate #1Q"), (c) 302,659 shares of common stock issued upon the conversion of 587,158 shares of Series A-1 preferred stock held by Originate #1A, (d) 668,353 shares of common stock issued upon the conversion of 1,296,605 shares of Series A-1 preferred stock held by Originate #1Q, (e) 53,912 shares of common stock issued upon the conversion of 104,589 shares of Series B preferred stock held by Originate #1A, (f) 119,055 shares of common stock issued upon the conversion of 230,968 shares of Series B preferred stock held by Originate #1Q, (g) 37,658 shares of common stock held by Originate #1A, (CONTINUED IN FOOTNOTE 2)
- [F2]and (h) 83,160 shares of common stock held by Originate #1Q.
- [F3]The general partner of both Originate #1Q and Originate #1A is Originate GP, LLC, a limited liability company. The members of Originate GP, LLC are Glen Bressner, Eric Arnson, and Michael Gausling. The members of Originate GP share voting and dispositive power over the shares held by Originate #1Q and Originate #1A. Mr. Gausling disclaims beneficial ownership of such shares, except to the extent of his pecuniary interest.
- [F4]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, 4:24 PM ET
- Size
- 18.4 KB