Statement of Changes in Beneficial Ownership (4)
November 29 2021 - 05:18PM
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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OMB
APPROVAL
OMB Number: 3235-0287
Estimated average burden
hours per response... 0.5 |
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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 * ADVENT INTERNATIONAL
CORP/MA |
2. Issuer Name and Ticker or Trading
Symbol ATI Physical Therapy, Inc. [ ATIP ] |
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
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(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
_ X _ Form filed by More than One Reporting
Person |
Table I - Non-Derivative Securities Acquired, Disposed of, or
Beneficially Owned
|
1.Title of Security
(Instr. 3) |
2. Trans. Date |
2A. Deemed Execution Date, if any |
3. Trans. Code
(Instr. 8) |
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5) |
5. Amount of Securities Beneficially Owned Following
Reported Transaction(s)
(Instr. 3 and 4) |
6. Ownership Form: Direct (D) or Indirect (I)
(Instr. 4) |
7. Nature of Indirect Beneficial Ownership (Instr.
4) |
|
Code |
V |
Amount |
(A) or (D) |
Price |
|
Class A Common Stock, par value $0.0001 per
share |
11/24/2021 |
|
J(1) |
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127468397 |
D |
(1) |
2831603 |
I |
See Notes (2)(3)(5) |
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Class A Common Stock, par value $0.0001 per
share |
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|
|
|
|
|
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115830656 (4) |
I |
See Notes (4)(5) |
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible
securities)
|
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 |
|
|
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 |
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WILCO GP, INC., By: /s/ John Maldonado, Name:
John Maldonado, Title: President |
|
11/29/2021 |
| **Signature of Reporting
Person |
Date |
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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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