Filing Details

Accession Number:
0001209191-10-030796
Form Type:
4
Zero Holdings:
No
Publication Time:
2010-05-27 13:00:00
Reporting Period:
2010-05-25
Filing Date:
2010-05-27
Accepted Time:
2010-05-27 15:27:39
SEC Url:
Form 4 Filing
Issuer
Cik Name Symbol Sector (SIC) IRS No
1472595 Accretive Health Inc. AH Services-Management Services (8741) 020698101
Insiders
Cik Name Reported Address Insider Title Director Officer Large Shareholder Other
1188406 P George Shultz C/O Accretive Health, Inc.
401 North Michigan Avenue, Suite 2700
Chicago IL 60611
Yes No No 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 2010-05-25 358,164 $0.00 710,964 No 4 C Indirect By The Shultz 1989 Family Trust
Common Stock Disposition 2010-05-25 33,844 $11.28 677,120 No 4 S Indirect By The Shultz 1989 Family Trust
Common Stock Acquisiton 2010-05-25 11,052 $12.00 688,172 No 4 J Indirect By The Shultz 1989 Family Trust
Equity Swap Involved Form Type Code Nature of Ownership Explanation
No 4 C Indirect By The Shultz 1989 Family Trust
No 4 S Indirect By The Shultz 1989 Family Trust
No 4 J Indirect By The Shultz 1989 Family Trust
Reported Derivative Transactions
Sec. Name Sec. Type Acquisiton - Disposition Date Amount Price Amount - 2 Price - 2
Common Stock Series A Convertible Preferred Stock Disposition 2010-05-25 263 $0.00 315,828 $0.00
Common Stock Series D Convertible Preferred Stock Disposition 2010-05-25 10,800 $0.00 42,336 $0.00
Remaning Holdings Exercise Date Expiration Date Equity Swap Involved Transaction Form Type Transaction Code Nature of Ownership
0 No 4 C Indirect
0 No 4 C Indirect
Footnotes
  1. The shares are held in a trust, the beneficiaries of which are Mr. Shultz and his wife.
  2. Reflects shares of Common Stock received in satisfaction of a liquidation preference payment required to be paid to the The Shultz 1989 Family Trust upon the closing of the Issuer's initial public offering.
  3. The Series A Convertible Preferred Stock automatically converted into the Issuer's common stock immediately prior to the closing of the Issuer's initial public offering on a 1,201.5069 for one basis and had no expiration date.
  4. The Series D Convertible Preferred Stock automatically converted into the Issuer's common stock immediately prior to the closing of the Issuer's initial public offering on a 3.92 for one basis and had no expiration date.