SEC Form 4/A · accession 0000899243-16-032157
Advanced Disposal Services, Inc. · ADSW
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
Richard L. Burke Jr.
Officer — Chief Exec. Officer & Director
Period of report
Oct 12, 2016
Accepted (ET)
Oct 21, 2016 · 4:04 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001585790
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | Oct 12, 2016 | A | 111,111 | — | A | 167,633 | D | |
| Common StockF2 | Oct 12, 2016 | A | 14,404 | — | A | 182,037 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Employee Stock Option (right to buy)F3 | $17.70 | Oct 12, 2016 | A | 446,643 | A | — | Nov 20, 2022 | Common Stock | 446,643 | 446,643 | D |
Explanation of responses
- F1Shares of Common Stock subject to a grant of restricted stock units made in connection with the Issuer's initial public offering. The award will vest in full on the third anniversary of the date of grant (the date of grant being 10/12/2016). This report amends the original Form 4 filed by the Reporting Person on October 14, 2016 to correct the number of shares included in such grant of the restricted stock units, which initially was reported as 111,112 shares. In addition, the amount of securities beneficially owned, as reported in column 5, has been adjusted by one share on both rows of Table I.
- F2Shares of Common Stock subject to a grant of restricted stock units made to replace restricted stock units of equivalent value that covered common stock of Advanced Disposal Waste Holdings ("Parent") and were cancelled in connection with the merger of Parent into the Issuer with the Issuer as the surviving corporation (the "Merger"). The award will vest in three equal installments over each of the first three anniversaries of the date of grant (date of grant being 6/24/2016).
- F3Option award that was granted to replace options of equivalent intrinsic value that covered common stock of Parent and were cancelled in connection with the Merger. This option fully vested in connection with its grant upon the Reporting Person's appointment as the Issuer's Chief Executive Officer. This report amends the original Form 4 filed by the Reporting Person on October 14, 2016 to correct the number of shares included in such grant of options, which initially was reported as 446,644 shares. The original Form 4 also reported on Table II a grant of 3,522 options having an exercise price of $24.29 that are not properly attributed to the Reporting Person, and such options are hereby removed from this report.