SEC Form 4
FORM 4 | UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP 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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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). |
1. Name and Address of Reporting Person*
(Street)
| 2. Issuer Name and Ticker or Trading Symbol Civitas Solutions, Inc. [ CIVI ] | 5. Relationship of Reporting Person(s) to Issuer (Check all applicable)
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3. Date of Earliest Transaction (Month/Day/Year) 10/07/2015 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed (Month/Day/Year) | 6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | ||||||||||
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1. Title of Security (Instr. 3) | 2. Transaction Date (Month/Day/Year) | 2A. Deemed Execution Date, if any (Month/Day/Year) | 3. Transaction 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 | ||||||
Common Stock | 10/07/2015 | S | 853,920(1) | D | $21.5(1) | 14,557,836 | I | By Vestar Capital Partners V, L.P.(2) | ||
Common Stock | 10/07/2015 | S | 234,850(1) | D | $21.5(1) | 4,003,741 | I | By Vestar Capital Partners V-A, L.P.(3) | ||
Common Stock | 10/07/2015 | S | 30,922(1) | D | $21.5(1) | 527,168 | I | By Vestar Capital Partners V-B, L.P.(4) | ||
Common Stock | 10/07/2015 | S | 30,304(1) | D | $21.5(1) | 516,634 | I | By Vestar/NMH Investors, LLC(5) |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||||||||||
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1. Title of Derivative Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction 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 (Month/Day/Year) | 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: 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 |
1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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Explanation of Responses: |
1. Represents shares of common stock sold in an underwritten offering. The sale price received by the reporting person will be reduced by the underwriters' commission of $1.12875 per share. |
2. These shares are held directly by the Vestar Capital Partners V, L.P. (the "Fund"). Vestar Associates V, L.P ("Vestar Associates V") is the general partner of the Fund. Vestar Managers V Ltd. ("VMV") is the general partner of Vestar Associates V. Mr. O'Connell is the sole director of VMV. As a result of these relationships, each of Vestar Associates V, VMV and Mr. O'Connell may be deemed to have beneficial ownership of the shares held directly by the Fund. Each of Vestar Associates V, VMV and Mr. O'Connell disclaims beneficial ownership of the securities beneficially owned by the Fund, except to the extent of its or his respective pecuniary interest therein. |
3. These shares are held directly by Vestar Capital Partners V-A, L.P. ("Fund V-A"). Vestar Associates V is the general partner of Fund V-A. VMV is the general partner of Vestar Associates V. Mr. O'Connell is the sole director of VMV. As a result of these relationships, each of Vestar Associates V, VMV and Mr. O'Connell may be deemed to have beneficial ownership of the shares held directly by Fund V-A. Each of Vestar Associates V, VMV and Mr. O'Connell disclaims beneficial ownership of the securities beneficially owned by Fund V-A, except to the extent of its or his respective pecuniary interest therein. |
4. These shares are held directly by Vestar Capital Partners V-B, L.P. ("Fund V-B"). Vestar Associates V is the general partner of Fund V-B. VMV is the general partner of Vestar Associates V. Mr. O'Connell is the sole director of VMV. As a result of these relationships, each of Vestar Associates V, VMV and Mr. O'Connell may be deemed to have beneficial ownership of the shares held directly by Fund V-B. Each of Vestar Associates V, VMV and Mr. O'Connell disclaims beneficial ownership of the securities beneficially owned by Fund V-B, except to the extent of its or his respective pecuniary interest therein. |
5. These shares are held directly by Vestar/NMH Investors. The Fund is the managing member of Vestar/NMH Investors, and Vestar Executives V, L.P. ("Vestar Executives V") and Vestar Co-Invest V, L.P. ("Vestar Co-Invest V") are members of Vestar/NMH Investors. Vestar Associates V is the general partner of the Fund and Vestar Executives V. VMV is the general partner of Vestar Associates V and Vestar Co-Invest V. Mr. O'Connell is the sole director of VMV. As a result of these relationships, each of Vestar Executives V, Vestar Co-Invest V, Vestar Associates V, VMV and Mr. O'Connell may be deemed to have beneficial ownership of the shares held directly by Vestar/NMH Investors. Each of Vestar Executives V, Vestar Co-Invest V, Vestar Associates V, VMV and Mr. O'Connell disclaims beneficial ownership of the securities beneficially owned by Vestar/NMH Investors, except to the extent of its or his respective pecuniary interest therein. |
Remarks: |
Vestar Capital Partners V, L.P., by /s/ Steven Della Rocca, by power of attorney | 10/09/2015 | |
Vestar Capital Partners V-A, L.P., by /s/ Steven Della Rocca, by power of attorney | 10/09/2015 | |
Vestar Capital Partners V-B, L.P., by /s/ Steven Della Rocca, by power of attorney | 10/09/2015 | |
Vestar/NMH Investors, LLC, by /s/ Steven Della Rocca, by power of attorney | 10/09/2015 | |
Vestar Executives V, L.P., by /s/ Steven Della Rocca, by power of attorney | 10/09/2015 | |
Vestar Co-Invest V, L.P., by /s/ Steven Della Rocca, by power of attorney | 10/09/2015 | |
Vestar Associates V, L.P., by /s/ Steven Della Rocca, by power of attorney | 10/09/2015 | |
Vestar Managers V Ltd., by /s/ Steven Della Rocca, by power of attorney | 10/09/2015 | |
Daniel S. O'Connell, by /s/ Steven Della Rocca, by power of attorney | 10/09/2015 | |
** Signature of Reporting Person | Date | |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | ||
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v). | ||
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). | ||
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |