4//SEC Filing
Tabula Rasa HealthCare, Inc. 4
Accession 0001192482-16-000723
CIK 0001651561operating
Filed
Oct 4, 8:00 PM ET
Accepted
Oct 5, 4:26 PM ET
Size
21.6 KB
Accession
0001192482-16-000723
Insider Transaction Report
Form 4
ORIGINATE GROWTH FUND 1A LP
10% Owner
Transactions
- Conversion
Series A Preferred Stock
2016-10-04−916,766→ 0 total→ Common Stock (472,560 underlying) - Conversion
Common Stock
2016-10-04+53,912→ 866,789 total - Conversion
Series A-1 Preferred Stock
2016-10-04−587,158→ 0 total→ Common Stock (302,659 underlying) - Conversion
Common Stock
2016-10-04+472,560→ 510,218 total - Conversion
Series B Preferred Stock
2016-10-04−104,589→ 0 total→ Common Stock (53,912 underlying) - Conversion
Common Stock
2016-10-04+302,659→ 812,877 total
Originate Growth GP, LLC
10% Owner
Transactions
- Conversion
Common Stock
2016-10-04+302,659→ 812,877 total - Conversion
Series A-1 Preferred Stock
2016-10-04−587,158→ 0 total→ Common Stock (302,659 underlying) - Conversion
Common Stock
2016-10-04+472,560→ 510,218 total - Conversion
Common Stock
2016-10-04+53,912→ 866,789 total - Conversion
Series A Preferred Stock
2016-10-04−916,766→ 0 total→ Common Stock (472,560 underlying) - Conversion
Series B Preferred Stock
2016-10-04−104,589→ 0 total→ Common Stock (53,912 underlying)
BRESSNER GLEN R
Director10% Owner
Transactions
- Conversion
Series B Preferred Stock
2016-10-04−104,589→ 0 total→ Common Stock (53,912 underlying) - Conversion
Common Stock
2016-10-04+472,560→ 510,218 total - Conversion
Common Stock
2016-10-04+53,912→ 866,789 total - Conversion
Series A-1 Preferred Stock
2016-10-04−587,158→ 0 total→ Common Stock (302,659 underlying) - Conversion
Common Stock
2016-10-04+302,659→ 812,877 total - Conversion
Series A Preferred Stock
2016-10-04−916,766→ 0 total→ Common Stock (472,560 underlying)
Arnson Eric R
10% Owner
Transactions
- Conversion
Common Stock
2016-10-04+302,659→ 812,877 total - Conversion
Series B Preferred Stock
2016-10-04−104,589→ 0 total→ Common Stock (53,912 underlying) - Conversion
Common Stock
2016-10-04+472,560→ 510,218 total - Conversion
Common Stock
2016-10-04+53,912→ 866,789 total - Conversion
Series A-1 Preferred Stock
2016-10-04−587,158→ 0 total→ Common Stock (302,659 underlying) - Conversion
Series A Preferred Stock
2016-10-04−916,766→ 0 total→ Common Stock (472,560 underlying)
GAUSLING MICHAEL J
10% Owner
Transactions
- Conversion
Series A Preferred Stock
2016-10-04−916,766→ 0 total→ Common Stock (472,560 underlying) - Conversion
Series B Preferred Stock
2016-10-04−104,589→ 0 total→ Common Stock (53,912 underlying) - Conversion
Common Stock
2016-10-04+302,659→ 812,877 total - Conversion
Common Stock
2016-10-04+472,560→ 510,218 total - Conversion
Common Stock
2016-10-04+53,912→ 866,789 total - Conversion
Series A-1 Preferred Stock
2016-10-04−587,158→ 0 total→ Common Stock (302,659 underlying)
Footnotes (3)
- [F1]Originate Growth Fund #1A, L.P. ("Originate #1A"), Originate #1A was the record holder of 916,766 shares of Series A Preferred Stock, which automatically converted into 472,560 shares of common stock upon the closing of the Issuer's initial public offering. Originate #1A was the record holder of 587,158 shares of Series A-1 Preferred Stock, which automatically converted into 302,659 shares of common stock upon the closing of the Issuer's initial public offering. Originate #1A was the record holder of 104,589 shares of Series B Preferred Stock, which automatically converted into 53,912 shares of common stock upon the closing of the Issuer's initial public offering.
- [F2]This report is filed jointly by Originate #1A, Originate Growth GP, LLC ("Originate GP"), Glen Bressner ("Bressner"), Eric Arnson ("Arnson"), and Michael Gausling ("Gausling"). The shares are held by Originate #1A. The general partner of Originate #1A 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 #1A. 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, 4:26 PM ET
- Size
- 21.6 KB