SEC Form 4 · accession 0001643498-17-000001
Evolent Health, Inc. · EVH
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Thomas Peterson III
Officer — Chief Operating Officer
Period of report
May 10, 2017
Accepted (ET)
May 12, 2017 · 7:18 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001628908
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Class A Common Stock | May 10, 2017 | M | 6,265 | $3.84 | A | 395,587 | D | |
| Class A Common StockF2 | May 10, 2017 | S | 6,265 | $25.00 | D | 391,322 | D | |
| Class A Common StockF3 | May 10, 2017 | S | 12,339 | $25.00 | D | 378,983 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Class A Common Stock Option (right to buy)F4 | $3.84 | May 10, 2017 | M | 6,265 | D | — | Apr 1, 2024 | Class A Common Stock | 6,265 | 201,635 | D |
Explanation of responses
- F1The transactions reported in this Form 4 were effected pursuant to a Rule 10b5-1 trading plan adopted by the reporting person on September 9, 2016.
- F2The price reported in Column 4 is a weighted average. These shares sold in multiple transactions at prices ranging from $25.00-$25.025, inclusive. The reporting person undertakes to provide to Evolent Health, Inc., any security holder of Evolent Health, Inc., or the Staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the range set forth in this footnote.
- F3The price reported in Column 4 is a weighted average. These shares were sold in multiple transactions at prices ranging from $25.00-$25.025, inclusive. The reporting person undertakes to provide to Evolent Health, Inc., any security holder of Evolent Health, Inc., or the Staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the range set forth in this footnote.
- F4The Class A Common Stock Options exercised began vesting at a rate of 25% annually beginning December 15, 2014.