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Filing Details

Accession Number:
0001209191-13-004152
Form Type:
4
Zero Holdings:
No
Publication Time:
2013-01-23 21:01:11
Reporting Period:
2013-01-21
Filing Date:
2013-01-23
Filing Date Changed:
2013-01-23
Accepted Time:
2013-01-23 21:01:11
SEC Url:
Form 4 Filing
Issuer
Cik Name Symbol Sector (SIC) IRS No
1220754 Providence Service Corp PRSC Services-Social Services (8300) 860845127
Insiders
Cik Name Reported Address Insider Title Director Officer Large Shareholder Other
1409751 Coliseum Capital Management, Llc Metro Center
1 Station Place, 7Th Floor South
Stamford CT 06902
No No Yes No
1430708 S Christopher Shackelton Metro Center
1 Station Place, 7Th Floor South
Stamford CT 06902
Yes No Yes No
Reported Non-Derivative Transactions
Sec. Name Acquisiton - Disposition Date Amount Price Remaning Holdings Equity Swap Involved Form Type Code Nature of Ownership Explanation
Common Stock Acquisiton 2013-01-21 12,500 $0.00 2,334,850 No 4 P Indirect See Footnote
Equity Swap Involved Form Type Code Nature of Ownership Explanation
No 4 P Indirect See Footnote
Footnotes
  1. These represent restricted stock units received by Coliseum Capital Partners, L.P. ("CCP") pursuant to an agreement under which Christopher Shackelton assigned to CCP the right to receive all compensation (including equity compensation) that Mr. Shackelton would otherwise receive as a director of The Providence Service Corporation.
  2. These securities are held directly by (a) CCP, of which Coliseum Capital, LLC, a Delaware limited liability company ("CC"), is general partner and for which Coliseum Capital Management, LLC, a Delaware limited liability company ("CCM"), serves as investment adviser, (b) Coliseum Capital Partners II, L.P., an investment limited partnership ("CCP2"), of which CC is general partner and for which CCM serves as investment adviser, and (c) Blackwell Partners, LLC ("Blackwell"), a separate account investment advisory client of CCM. Each of Christopher Shackelton, Adam Gray, CCP, CCP2, Blackwell, CC and CCM disclaim beneficial ownership of these securities except to the extent of that person's pecuniary interest therein. Christopher Shackelton is the Chairman of the board of directors of The Providence Service Corporation.