Form 4 - Statement of changes in beneficial ownership of securities
29 10월 2024 - 9:46AM
Edgar (US Regulatory)
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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OMB APPROVAL |
OMB Number: |
3235-0287 |
Estimated average burden |
hours per response: |
0.5 |
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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). |
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Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan for the purchase or sale of equity securities of the issuer that is intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10. |
1. Name and Address of Reporting Person*
C/O ADAPTHEALTH LLC |
220 WEST GERMANTOWN PIKE, SUITE 250 |
(Street)
PLYMOUTH MEETING |
PA |
19462 |
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2. Issuer Name and Ticker or Trading Symbol
AdaptHealth Corp.
[ AHCO ]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X |
Director |
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10% Owner |
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Officer (give title below) |
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Other (specify below) |
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3. Date of Earliest Transaction
(Month/Day/Year) 10/24/2024
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4. If Amendment, Date of Original Filed
(Month/Day/Year)
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6. Individual or Joint/Group Filing (Check Applicable Line)
X |
Form filed by One Reporting Person |
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Form filed by More than One Reporting Person |
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned |
1. Title of Security (Instr.
3)
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2. Transaction Date
(Month/Day/Year) |
2A. Deemed Execution Date, if any
(Month/Day/Year) |
3. Transaction Code (Instr.
8)
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4. Securities Acquired (A) or Disposed Of (D) (Instr.
3, 4 and 5)
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5.
Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr.
3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr.
4)
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7. Nature of Indirect Beneficial Ownership (Instr.
4)
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Code |
V |
Amount |
(A) or (D) |
Price |
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)
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2. Conversion or Exercise Price of Derivative Security
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3. Transaction Date
(Month/Day/Year) |
3A. Deemed Execution Date, if any
(Month/Day/Year) |
4. Transaction Code (Instr.
8)
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5.
Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr.
3, 4 and 5)
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6. Date Exercisable and Expiration Date
(Month/Day/Year) |
7. Title and Amount of Securities Underlying Derivative Security (Instr.
3 and 4)
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8. Price of Derivative Security (Instr.
5)
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9.
Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr.
4)
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10. Ownership Form: Direct (D) or Indirect (I) (Instr.
4)
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11. Nature of Indirect Beneficial Ownership (Instr.
4)
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Code |
V |
(A) |
(D) |
Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
Employee Stock Option (right to buy) |
$11.5
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10/24/2024 |
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D
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833,334 |
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11/29/2024 |
Common Stock |
833,334 |
$0
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0 |
D |
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Employee Stock Option (right to buy) |
$11.5
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10/24/2024 |
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A
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833,334 |
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03/31/2025 |
Common Stock |
833,334 |
$0
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833,334 |
D |
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Explanation of Responses: |
Remarks: |
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/s/ Jonathan Bush, as attorney-in-fact for Josh Parnes |
10/28/2024 |
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** 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. |
Exhibit 24
Power of Attorney
Know all by these
presents, that the undersigned hereby makes, constitutes and appoints each of Jonathan B. Bush and Shannone Raybon, the undersigned’s
true and lawful attorney-in-fact (each of such persons and their substitutes being referred to herein as the “Attorney-in-Fact”
and, collectively, the “Attorneys-in-Fact”), each with full power of substitution and resubsitution, and to act for the undersigned
and in the undersigned's name, place and stead, in any and all capacities, to:
| 1. | Prepare, execute, and submit to the Securities and Exchange Commission ("SEC") a Form ID, including
amendments thereto, and any other documents necessary or appropriate to obtain codes and passwords enabling the undersigned to make electronic
filings with the SEC of reports required or considered by the Attorney-in-Fact to be advisable under Section 13 or Section 16 of the Securities
Exchange Act of 1934 (the "Exchange Act") or any rule or regulation of the SEC; |
| 2. | Prepare, execute and submit to the SEC, AdaptHealth Corp. (the “Company”), and/or any national
securities exchange on which the Company’s securities are listed any and all reports (including any amendments thereto) the undersigned,
in the undersigned's capacity as an officer, director and/or 10% or more stockholder of the Company, is required to file with the SEC,
or which the Attorneys-in-Fact consider it advisable to file with the SEC, under Section 13 or Section 16 of the Exchange Act or any rule
or regulation thereunder, or under Rule 144 under the Securities Act of 1933 (“Rule 144”), with respect to the any security
of the Company, including Forms 3, 4 and 5, Schedules 13D and 13G, and Forms 144; and |
| 3. | Obtain, as the undersigned's representative and on the undersigned's behalf, information regarding transactions
in the Company's equity securities from any third party, including the Company and any brokers, dealers, employee benefit plan administrators
and trustees, and the undersigned hereby authorizes any such third party to release any such information to the Attorneys-in-Fact. |
The undersigned acknowledges that:
| a) | This Power of Attorney authorizes, but does not require, each Attorney-in-Fact to act in his or her discretion
on information provided to such Attorney-in-Fact without independent verification of such information; |
| b) | Any documents prepared or executed by either Attorney-in-Fact on behalf of the undersigned pursuant to
this Power of Attorney will be in such form and will contain such information as such Attorney-in-Fact, in his or her discretion, deems
necessary or desirable; |
| c) | Neither the Company nor the Attorneys-in-Fact assume any liability for the undersigned's responsibility
to comply with the requirements of Section 13 or Section 16 of the Exchange Act or Rule 144, any liability of the undersigned for any
failure to comply with such requirements, or any liability of the undersigned for disgorgement of profits under Section 16(b) of the Exchange
Act; and |
| d) | This Power of Attorney does not relieve the undersigned from responsibility for compliance with the undersigned's
obligations under Section 13 or Section 16 of the Exchange Act, including, without limitation, the reporting requirements under Section
13 or Section 16 of the Exchange Act. |
The undersigned hereby
grants to each Attorney-in-Fact full power and authority to do and perform each and every act and thing requisite, necessary or
advisable to be done in connection with the foregoing, as fully, to all intents and purposes, as the undersigned might or could do
in person, hereby ratifying and confirming all that the Attorney-in-Fact, or his or her substitute or substitutes, shall lawfully do
or cause to be done by authority of this Power of Attorney.
This Power of Attorney shall remain in full force and effect until
the undersigned is no longer required to file Forms 4 or 5 or Schedules 13D or 13G or Forms 144 with respect to the undersigned's holdings
of and transactions in securities of the Company, unless earlier revoked by the undersigned in a signed writing delivered to either Attorney-in-Fact.
This Power of Attorney revokes all previous powers of attorney with respect to the subject matter of this Power of Attorney.
IN WITNESS WHEREOF, the undersigned has executed this Power
of Attorney as of April 16, 2024.
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/s/ Josh Parnes |
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By: Josh Parnes |
Exhibit 24
Power of Attorney
Know all by these
presents, that the undersigned hereby makes, constitutes and appoints each of Jonathan B. Bush and Shannone Raybon, the undersigned’s
true and lawful attorney-in-fact (each of such persons and their substitutes being referred to herein as the “Attorney-in-Fact”
and, collectively, the “Attorneys-in-Fact”), each with full power of substitution and resubsitution, and to act for the undersigned
and in the undersigned's name, place and stead, in any and all capacities, to:
| 1. | Prepare, execute, and submit to the Securities and Exchange Commission ("SEC") a Form ID, including
amendments thereto, and any other documents necessary or appropriate to obtain codes and passwords enabling the undersigned to make electronic
filings with the SEC of reports required or considered by the Attorney-in-Fact to be advisable under Section 13 or Section 16 of the Securities
Exchange Act of 1934 (the "Exchange Act") or any rule or regulation of the SEC; |
| 2. | Prepare, execute and submit to the SEC, AdaptHealth Corp. (the “Company”), and/or any national
securities exchange on which the Company’s securities are listed any and all reports (including any amendments thereto) the undersigned,
in the undersigned's capacity as an officer, director and/or 10% or more stockholder of the Company, is required to file with the SEC,
or which the Attorneys-in-Fact consider it advisable to file with the SEC, under Section 13 or Section 16 of the Exchange Act or any rule
or regulation thereunder, or under Rule 144 under the Securities Act of 1933 (“Rule 144”), with respect to the any security
of the Company, including Forms 3, 4 and 5, Schedules 13D and 13G, and Forms 144; and |
| 3. | Obtain, as the undersigned's representative and on the undersigned's behalf, information regarding transactions
in the Company's equity securities from any third party, including the Company and any brokers, dealers, employee benefit plan administrators
and trustees, and the undersigned hereby authorizes any such third party to release any such information to the Attorneys-in-Fact. |
The undersigned acknowledges that:
| a) | This Power of Attorney authorizes, but does not require, each Attorney-in-Fact to act in his or her discretion
on information provided to such Attorney-in-Fact without independent verification of such information; |
| b) | Any documents prepared or executed by either Attorney-in-Fact on behalf of the undersigned pursuant to
this Power of Attorney will be in such form and will contain such information as such Attorney-in-Fact, in his or her discretion, deems
necessary or desirable; |
| c) | Neither the Company nor the Attorneys-in-Fact assume any liability for the undersigned's responsibility
to comply with the requirements of Section 13 or Section 16 of the Exchange Act or Rule 144, any liability of the undersigned for any
failure to comply with such requirements, or any liability of the undersigned for disgorgement of profits under Section 16(b) of the Exchange
Act; and |
| d) | This Power of Attorney does not relieve the undersigned from responsibility for compliance with the undersigned's
obligations under Section 13 or Section 16 of the Exchange Act, including, without limitation, the reporting requirements under Section
13 or Section 16 of the Exchange Act. |
The undersigned hereby
grants to each Attorney-in-Fact full power and authority to do and perform each and every act and thing requisite, necessary or
advisable to be done in connection with the foregoing, as fully, to all intents and purposes, as the undersigned might or could do
in person, hereby ratifying and confirming all that the Attorney-in-Fact, or his or her substitute or substitutes, shall lawfully do
or cause to be done by authority of this Power of Attorney.
This Power of Attorney shall remain in full force and effect until
the undersigned is no longer required to file Forms 4 or 5 or Schedules 13D or 13G or Forms 144 with respect to the undersigned's holdings
of and transactions in securities of the Company, unless earlier revoked by the undersigned in a signed writing delivered to either Attorney-in-Fact.
This Power of Attorney revokes all previous powers of attorney with respect to the subject matter of this Power of Attorney.
IN WITNESS WHEREOF, the undersigned has executed this Power
of Attorney as of April 16, 2024.
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/s/ Josh Parnes |
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By: Josh Parnes |
AdaptHealth (NASDAQ:AHCO)
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AdaptHealth (NASDAQ:AHCO)
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