Statement of Changes in Beneficial Ownership (4)
29 November 2021 - 11:18PM
Edgar (US Regulatory)
FORM 4
[ ]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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3235-0287
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Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
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ADVENT INTERNATIONAL CORP/MA |
2. Issuer Name and Ticker or Trading Symbol
ATI Physical Therapy, Inc.
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ATIP
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director __X__ 10% Owner _____ Officer (give title below) _____ Other (specify below)
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(Last)
(First)
(Middle)
PRUDENTIAL TOWER, 800 BOYLSTON, STREET, SUITE 3300 |
3. Date of Earliest Transaction
(MM/DD/YYYY)
11/24/2021 |
(Street)
BOSTON, MA 02199-8069
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
___ Form filed by One Reporting Person
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X
_ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security (Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code (Instr. 8)
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4. Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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Class A Common Stock, par value $0.0001 per share | 11/24/2021 | | J(1) | | 127468397 | D | (1) | 2831603 | I | See Notes (2)(3)(5) |
Class A Common Stock, par value $0.0001 per share | | | | | | | | 115830656 (4) | I | See Notes (4)(5) |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Trans. Date | 3A. Deemed Execution Date, if any | 4. Trans. Code (Instr. 8) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) | 6. Date Exercisable and Expiration Date | 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) | 8. Price of Derivative Security (Instr. 5) | 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) | 10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) |
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Explanation of Responses: |
(1) | See Exhibit 99.1 for text of footnote (1). |
(2) | See Exhibit 99.1 for text of footnote (2). |
(3) | See Exhibit 99.1 for text of footnote (3). |
(4) | See Exhibit 99.1 for text of footnote (4). |
(5) | See Exhibit 99.1 for text of footnote (5). |
Remarks: Exhibit 99.1 (Footnotes to Form 4) is incorporated by reference. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
ADVENT INTERNATIONAL CORP/MA PRUDENTIAL TOWER, 800 BOYLSTON STREET, SUITE 3300 BOSTON, MA 02199-8069 |
| X |
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Wilco Acquisition, LP PRUDENTIAL TOWER 800 BOYLSTON STREET, SUITE 3300 BOSTON, MA 02199-8069 |
| X |
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Wilco GP, Inc. PRUDENTIAL TOWER 800 BOYLSTON STREET, SUITE 3300 BOSTON, MA 02199-8069 |
| X |
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Signatures
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ADVENT INTERNATIONAL CORPORATION, By: /s/ Neil Crawford, Name: Neil Crawford, Title: Director, Fund Administration | | 11/29/2021 |
**Signature of Reporting Person | Date |
WILCO GP, INC., By: /s/ John Maldonado, Name: John Maldonado, Title: President | | 11/29/2021 |
**Signature of Reporting Person | Date |
WILCO ACQUISITION, LP, By: Wilco GP, Inc., By: /s/ John Maldonado, Name: John Maldonado, Title: President | | 11/29/2021 |
**Signature of Reporting Person | Date |
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