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Share Name | Share Symbol | Market | Type |
---|---|---|---|
R1 RCM Inc | NASDAQ:RCM | NASDAQ | Common Stock |
Price Change | % Change | Share Price | Bid Price | Offer Price | High Price | Low Price | Open Price | Shares Traded | Last Trade | |
---|---|---|---|---|---|---|---|---|---|---|
0.14 | 1.13% | 12.50 | 12.45 | 12.49 | 12.55 | 12.19 | 12.37 | 962,204 | 00:59:54 |
FORM 4
[ ]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue.
See
Instruction 1(b).
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
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OMB APPROVAL
OMB Number: 3235-0287 Estimated average burden hours per response... 0.5 |
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1. Name and Address of Reporting Person
*
TCP-ASC ACHI Series LLLP |
2. Issuer Name
and
Ticker or Trading Symbol
R1 RCM INC. [ ACHI ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__ X __ Director __ X __ 10% Owner _____ Officer (give title below) _____ Other (specify below) |
2711 CENTERVILLE ROAD, SUITE 400, |
3. Date of Earliest Transaction
(MM/DD/YYYY)
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WILMINGTON, DE 19808 |
4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
___ Form filed by One Reporting Person _ X _ Form filed by More than One Reporting Person |
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned |
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1.Title of Security
(Instr. 3) |
2. Trans. Date | 2A. Deemed Execution Date, if any |
3. Trans. 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 |
Table II - Derivative Securities Beneficially Owned ( e.g. , puts, calls, warrants, options, convertible securities) |
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1. Title of Derivate Security
(Instr. 3) |
2. Conversion or Exercise Price of Derivative Security | 3. Trans. Date | 3A. Deemed Execution Date, if any |
4. Trans. 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 |
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 of Derivative Security: 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 | ||||||||
8.00% Series A Convertible Preferred Stock | $2.50 | 1/3/2017 | A | 4203 | (1) | (1) | Common Stock, par value $0.01 per share | 1681200 | (2) | 214363 | D (2) (3) (4) (5) (6) |
Remarks:
For purposes of Section 16 of the Securities Exchange Act of 1934, as amended, the Reporting Persons may be deemed to be directors by deputization by virtue of their contractual right to appoint directors to the board of directors of the Issuer. As a result, the "Director" box is marked in Item 5 of this Form 4. |
Reporting Owners
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Reporting Owner Name / Address |
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Director | 10% Owner | Officer | Other | ||
TCP-ASC ACHI Series LLLP
2711 CENTERVILLE ROAD, SUITE 400 WILMINGTON, DE 19808 |
X | X |
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TCP-ASC GP, LLC
2711 CENTERVILLE ROAD, SUITE 400 WILMINGTON, DE 19808 |
X | X |
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TI IV ACHI Holdings GP, LLC
2711 CENTERVILLE ROAD, SUITE 400 WILMINGTON, DE 19808 |
X | X |
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TI IV ACHI Holdings, LP
2711 CENTERVILLE ROAD, SUITE 400 WILMINGTON, DE 19808 |
X | X |
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TowerBrook Investors, Ltd.
C/O TOWERBROOK CAPITAL PARTNERS L.P. 66 EAST 55TH STREET, 27TH FLOOR NEW YORK, NY 10022 |
X | X |
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MOSZKOWSKI NEAL
C/O TOWERBROOK CAPITAL PARTNERS L.P. 66 EAST 55TH STREET, 27TH FLOOR NEW YORK, NY 10022 |
X | X |
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SOUSOU RAMEZ
KINNIARD HOUSE 1 PALL MALL EAST LONDON, X0 SW1Y 5AU |
X | X |
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Ascension Health Alliance
101 S. HANLEY ROAD, SUITE 450 ST. LOUIS, MO 63105 |
X | X |
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Signatures
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/s/ TCP-ASC ACHI Series LLLP, by TCP-ASC GP, LLC, its General Partner, by Glenn F. Miller, Vice President | 1/5/2017 | |
** Signature of Reporting Person |
Date
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/s/ TCP-ASC GP, LLC by Glenn F. Miller, Vice President | 1/5/2017 | |
** Signature of Reporting Person |
Date
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/s/ TI IV ACHI Holdings GP, LLC by Glenn F. Miller, Vice President | 1/5/2017 | |
** Signature of Reporting Person |
Date
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/s/ TI IV ACHI Holdings, LP, by TI IV ACHI Holdings GP, LLC, its General Partner, by Glenn F. Miller, Vice President | 1/5/2017 | |
** Signature of Reporting Person |
Date
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/s/ TowerBrook Investors Ltd. by Neal Moszkowski, Director | 1/5/2017 | |
** Signature of Reporting Person |
Date
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/s/ Neal Moszkowski | 1/5/2017 | |
** Signature of Reporting Person |
Date
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/s/ Ramez Sousou | 1/5/2017 | |
** Signature of Reporting Person |
Date
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/s/ Ascension Health Alliance by Anthony J. Speranzo, Executive Vice President & Chief Financial Officer | 1/5/2017 | |
** Signature of Reporting Person |
Date
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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 control number. |
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