SEC Form 4 · accession 0001209191-15-006248

PROVIDENCE SERVICE CORP · PRSC

Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗

Reporting owners

COLISEUM CAPITAL PARTNERS L P

Director · 10% Owner

Coliseum Capital, LLC

Director · 10% Owner

Coliseum Capital Management, LLC

Director · 10% Owner

BLACKWELL PARTNERS LLC - SERIES A

Director · 10% Owner

Christopher S Shackelton

Director · 10% Owner

Director · 10% Owner

Coliseum Capital Partners II, L.P.

Director · 10% Owner

Coliseum Capital Co-Invest, L.P.

Director · 10% Owner

Period of report

Jan 21, 2015

Accepted (ET)

Jan 23, 2015 · 5:08 pm EST

Rule 10b5-1 plan

unknown — predates the checkbox

Issuer CIK

0001220754

Table I — non-derivative securities

Security	Date	Code	Shares	Price	A/D	Owned after	D/I	Nature of ownership
Common Stock^F1	Jan 21, 2015	M	4,167	—	A	2,226,468	I	See Footnote
Common Stock^F1	Jan 21, 2015	D	4,167	$37.31	D	2,222,301	I	See Footnote

Table II — derivative securities

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	Owned after	D/I
Phantom Stock^F1	—	Jan 21, 2015	M	4,167	D	Jan 21, 2015	Jan 21, 2015	Common Stock	4,167	0	I

Explanation of responses

F1See Joint Filer Information on Exhibit 99.1 for information with respect to the nature of Coliseum Capital Management, LLC's indirect ownership and details regarding the transactions reported herein and the nature of the beneficial ownership of the reporting persons.

Remarks

Christopher Shackelton is a director of the Issuer. As a result, the following persons may be deemed directors by deputization of the Issuer solely for purposes of Section 16 of the Securities Exchange Act of 1934, as amended: Coliseum Capital Management, LLC; Coliseum Capital, LLC; Coliseum Capital Partners, L.P.; Coliseum Capital Partners II, L.P.; Blackwell Partners LLC Series A; Coliseum Capital Co-Invest, L.P. and Adam Gray.