SEC Form 4/A · accession 0001472595-18-000008
R1 RCM INC. · RCM
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
This is an amendment (Form 4/A). It replaces an earlier filing for the same period.
Reporting owner
Christopher Simon Ricaurte
Officer — Chief Financial Officer
Period of report
Dec 20, 2017
Accepted (ET)
Jan 18, 2018 · 8:22 am EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001472595
Table I — non-derivative securities
No Table I lines on this filing.
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Performance-Based Restricted Stock UnitsF2,F1,F3,F4,F5 | — | Dec 20, 2017 | A | 276,603 | A | — | — | Common Stock | 276,603 | 276,603 | D |
Explanation of responses
- F1Represents a contingent right to receive the Issuer's common stock.
- F2The Reporting Person's original Form 4 inadvertently reported the maximum number of PBRSUs available to be achieved by the Reporting Person rather than the target number of PBRSUs actually awarded to the Reporting Person.
- F3Pursuant to the award agreement, the performance-based restricted stock units will be subject to both a time-based vesting condition and a performance-based vesting condition. The time-based vesting condition may be satisfied on the earlier of December 31, 2020 and a qualifying change of control (the "Performance Period"), subject to the Reporting Person not having ceased to perform services with the Issuer. The performance-based vesting condition may be satisfied based upon an average per share price of the Issuer's common stock as defined in the award agreement, measured at the end of the Performance Period.
- F4Vested shares will be delivered within two and one-half months following the end of the calendar year in which or with respect to which both the time-based and performance-based vesting conditions were satisfied.
- F5Amount represents 100% of the target award. The number of shares earned will be based upon the achievement of a performance-based vesting condition and will range from 0% to 200% of the target award.