Statement of Changes in Beneficial Ownership (4)
November 13 2019 - 4:17PM
Edgar (US Regulatory)
FORM 4
[ ]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0287
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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. Name and Address of Reporting Person
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Deerfield/RAB Ventures, LLC |
2. Issuer Name and Ticker or Trading Symbol
AdaptHealth Corp.
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AHCO
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director __X__ 10% Owner
_____ Officer (give title below) _____ Other (specify below)
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(Last)
(First)
(Middle)
C/O ADAPTHEALTH HOLDING CORPORATION, 780 THIRD AVENUE, 37TH FLOOR |
3. Date of Earliest Transaction
(MM/DD/YYYY)
11/8/2019 |
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(Street)
NEW YORK, NY 10017
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
_X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security
(Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. 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
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V
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Amount
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(A) or (D)
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Price
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| Common Stock | 11/8/2019 | | J(1) | | 2373152 | D | $0.0 (1) | 3672500 | D | |
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 |
| Private Placement Warrant | $11.5 | 11/8/2019 | | J (1) | | | 1690000 | 12/8/2019 | 11/8/2024 | Common Stock | 1690000 | $0.0 (1) | 2643333 | D | |
| Explanation of Responses: |
| (1) | Pursuant to the Amended and Restated Assignment Letter Agreement dated October 15, 2019, by and among Deerfield/RAB Ventures, LLC (the "Sponsor"), DFB Healthcare Acquisitions Corp. ("DFB") and AdaptHealth Holdings, LLC ("AdaptHealth"), the Sponsor transferred and assigned 2,373,152 of its founder shares of DFB and 1,690,000 warrants to purchase shares of DFB's Class A Common Stock held by the Sponsor to certain members and employees of AdaptHealth, for no consideration. |
Reporting Owners
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| Reporting Owner Name / Address | Relationships |
| Director | 10% Owner | Officer | Other |
Deerfield/RAB Ventures, LLC
C/O ADAPTHEALTH HOLDING CORPORATION
780 THIRD AVENUE, 37TH FLOOR
NEW YORK, NY 10017 |
| X |
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Signatures
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| /s/ Alan I. Annex, Attorney-in-Fact | | 11/13/2019 |
| **Signature of Reporting Person | Date |
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