05/07/2024 | Press release | Distributed by Public on 05/07/2024 08:34
FORM 4
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES 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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1. Title of Derivate Security | 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 | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) | 6. Date Exercisable and Expiration Date | 7. Title and Amount of Securities Underlying Derivative Security | 8. Price of Derivative Security | 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) | 10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) | 11. Nature of Indirect Beneficial Ownership |
Code | V | (A) | (D) | Date Exercisable | Expriation Date | Title | Amount or Number of Shares |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
THL AGILITI LLC C/O THOMAS H. LEE PARTNERS, L.P. 100 FEDERAL STREET BOSTON, MA02110 |
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THL EQUITY FUND VIII INVESTORS (AGILITI), L.P. C/O THOMAS H. LEE PARTNERS, L.P. 100 FEDERAL STREET BOSTON, MA02110 |
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FS Sponsor LLC C/O THOMAS H. LEE PARTNERS, L.P. 100 FEDERAL STREET BOSTON, MA02110 |
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Bell Michael Adam C/O THOMAS H. LEE PARTNERS, L.P. 100 FEDERAL STREET BOSTON, MA02110 |
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Nelson Joshua M C/O THOMAS H. LEE PARTNERS, L.P. 100 FEDERAL STREET BOSTON, MA02110 |
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PREINER MEGAN M C/O THOMAS H. LEE PARTNERS, L.P. 100 FEDERAL STREET BOSTON, MA02110 |
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SPERLING SCOTT M C/O THOMAS H. LEE PARTNERS, L.P. 100 FEDERAL STREET BOSTON, MA02110 |
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THL AGILITI LLC By: /s/ Joshua M. Nelson Name: Joshua M. Nelson Title: Authorized Signatory | 2024-05-07 |
**Signature of Reporting Person | Date |
(*) | If the form is filed by more than one reporting person, see Instruction 5(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). |
(1) | See Exhibit 99.1 for text of Footnote 1. |
(2) | See Exhibit 99.1 for text of Footnote 2. |
(3) | See Exhibit 99.1 for text of Footnote 3. |
(4) | See Exhibit 99.1 for text of Footnote 4. |