Insider filing report for Changes in Beneficial Ownership
- Schedule 13G & 13D forms are used to report a party's ownership of stock which exceeds 5% of a company's total stock issue.
- Schedule 13G is a shorter version of Schedule 13D with fewer reporting requirements.
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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
SCHEDULE 13G
Under the Securities Exchange Act of 1934
(Amendment No. 1)*
Change Healthcare Inc.
(Name of Issuer)
Common Stock, par value $0.001 per share
(Title of Class of Securities)
15912K100
(CUSIP Number)
December 31, 2020
(Date of Event which Requires Filing of this Statement)
Check the appropriate box to designate the rule pursuant to which this Schedule is filed: specificity
☐ Rule 13d-1(b)
☐ Rule 13d-1(c)
☒ Rule 13d-1(d)
* | The remainder of this cover page shall be filled out for a reporting persons initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter disclosures provided in a prior cover page. |
The information required on the remainder of this cover page shall not be deemed to be filed for the purpose of Section 18 of the Securities Exchange Act of 1934 (Act) or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however, see the Notes).
CUSIP No. 15912K100
1. |
Name of Reporting Person
Hellman & Friedman LLC | |||||
2. | Check the Appropriate Box if a Member of a Group (a) ☐ (b) ☒
| |||||
3. | SEC Use Only
| |||||
4. | Citizenship or Place of Organization
Delaware |
Number of shares beneficially owned by each reporting person with |
5. | Sole Voting Power
0 | ||||
6. | Shared Voting Power
0 | |||||
7. | Sole Dispositive Power
0 | |||||
8. | Shared Dispositive Power
0 |
9. |
Aggregate Amount Beneficially Owned by Each Reporting Person
0 | |||||
10. | Check Box if the Aggregate Amount in Row (9) Excludes Certain Shares (See Instructions)
☐ | |||||
11. | Percent of Class Represented by Amount in Row (9)
0% | |||||
12. | Type of Reporting Person (See Instructions)
OO |
2
CUSIP No. 15912K100
1. |
Name of Reporting Person
Hellman & Friedman Investors VI, L.P. | |||||
2. | Check the Appropriate Box if a Member of a Group (a) ☐ (b) ☒
| |||||
3. | SEC Use Only
| |||||
4. | Citizenship or Place of Organization
Delaware |
Number of shares beneficially owned by each reporting person with |
5. | Sole Voting Power
0 | ||||
6. | Shared Voting Power
0 | |||||
7. | Sole Dispositive Power
0 | |||||
8. | Shared Dispositive Power
0 |
9. |
Aggregate Amount Beneficially Owned by Each Reporting Person
0 | |||||
10. | Check Box if the Aggregate Amount in Row (9) Excludes Certain Shares (See Instructions)
☐ | |||||
11. | Percent of Class Represented by Amount in Row (9)
0% | |||||
12. | Type of Reporting Person (See Instructions)
PN |
3
CUSIP No. 15912K100
1. |
Name of Reporting Person
H&F Harrington AIV II, L.P. | |||||
2. | Check the Appropriate Box if a Member of a Group (a) ☐ (b) ☒
| |||||
3. | SEC Use Only
| |||||
4. | Citizenship or Place of Organization
Delaware |
Number of shares beneficially owned by each reporting person with |
5. | Sole Voting Power
0 | ||||
6. | Shared Voting Power
0 | |||||
7. | Sole Dispositive Power
0 | |||||
8. | Shared Dispositive Power
0 |
9. |
Aggregate Amount Beneficially Owned by Each Reporting Person
0 | |||||
10. | Check Box if the Aggregate Amount in Row (9) Excludes Certain Shares (See Instructions)
☐ | |||||
11. | Percent of Class Represented by Amount in Row (9)
0% | |||||
12. | Type of Reporting Person (See Instructions)
PN |
4
CUSIP No. 15912K100
1. |
Name of Reporting Person
HFCP VI Domestic AIV, L.P. | |||||
2. | Check the Appropriate Box if a Member of a Group (a) ☐ (b) ☒
| |||||
3. | SEC Use Only
| |||||
4. | Citizenship or Place of Organization
Delaware |
Number of shares beneficially owned by each reporting person with |
5. | Sole Voting Power
0 | ||||
6. | Shared Voting Power
0 | |||||
7. | Sole Dispositive Power
0 | |||||
8. | Shared Dispositive Power
0 |
9. |
Aggregate Amount Beneficially Owned by Each Reporting Person
0 | |||||
10. | Check Box if the Aggregate Amount in Row (9) Excludes Certain Shares (See Instructions)
☐ | |||||
11. | Percent of Class Represented by Amount in Row (9)
0% | |||||
12. | Type of Reporting Person (See Instructions)
PN |
5
CUSIP No. 15912K100
1. |
Name of Reporting Person
Hellman & Friedman Capital Executives VI, L.P. | |||||
2. | Check the Appropriate Box if a Member of a Group (a) ☐ (b) ☒
| |||||
3. | SEC Use Only
| |||||
4. | Citizenship or Place of Organization
Delaware |
Number of shares beneficially owned by each reporting person with |
5. | Sole Voting Power
0 | ||||
6. | Shared Voting Power
0 | |||||
7. | Sole Dispositive Power
0 | |||||
8. | Shared Dispositive Power
0 |
9. |
Aggregate Amount Beneficially Owned by Each Reporting Person
0 | |||||
10. | Check Box if the Aggregate Amount in Row (9) Excludes Certain Shares (See Instructions)
☐ | |||||
11. | Percent of Class Represented by Amount in Row (9)
0% | |||||
12. | Type of Reporting Person (Se e Instructions)
PN |
6
CUSIP No. 15912K100
1. |
Name of Reporting Person
Hellman & Friedman Capital Associates VI, L.P. | |||||
2. | Check the Appropriate Box if a Member of a Group (a) ☐ (b) ☒
| |||||
3. | SEC Use Only
| |||||
4. | Citizenship or Place of Organization
Delaware |
Number of shares beneficially owned by each reporting person with |
5. | Sole Voting Power
0 | ||||
6. | Shared Voting Power
0 | |||||
7. | Sole Dispositive Power
0 | |||||
8. | Shared Dispositive Power
0 |
9. |
Aggregate Amount Beneficially Owned by Each Reporting Person
0 | |||||
10. | Check Box if the Aggregate Amount in Row (9) Excludes Certain Shares (See Instructions)
☐ | |||||
11. | Percent of Class Represented by Amount in Row (9)
0% | |||||
12. | Type of Reporting Person (See Instructions)
PN |
7
STATEMENT ON SCHEDULE 13G
This is Amendment No. 1 to the Schedule 13G filed with the Securities and Exchange Commission on February 14, 2020. Pursuant to Rule 13d-1(k) under the Securities Exchange Act of 1934, as amended (the Act), each of the persons listed below under Item 2 (each a Reporting Person, and collectively the Reporting Persons), have agreed to file one statement with respect to their beneficial ownership of common stock, par value $0.001 per share (Common Stock), of Change Healthcare Inc. (the Issuer).
Item 1.
(a) | Name of Issuer: |
Change Healthcare Inc.
(b) | Address of Issuers Principal Executive Offices: |
424 Church Street, Suite 1400
Nashville, TN 37219
Item 2.
(a) | Name of Person Filing: |
Hellman & Friedman LLC
Hellman & Friedman Investors VI, L.P.
H&F Harrington AIV II, L.P.
HFCP VI Domestic AIV, L.P.
Hellman & Friedman Capital Executives VI, L.P.
Hellman & Friedman Capital Associates VI, L.P.
(b) | Address of Principal Business Office, or, if None, Residence: |
The principal business office for all persons filing:
415 Mission Street, Suite 5700
San Francisco, CA 94105
(c) | Citizenship: |
See Item 4 of each cover page.
(d) | Title of Class of Securities: |
Common stock, par value $0.001 per share.
(e) | CUSIP Number: |
15912K100
Item 3.
Not applicable.
Item 4. | Ownership. |
(a) | Amount beneficially owned: 0 |
(b) | Percent of class: 0 |
(c) | Number of shares as to which the person has: |
(i) | Sole power to vote or to direct the vote: 0 |
(ii) | Shared power to vote or to direct the vote: 0 |
(iii) | Sole power to dispose or to direct the disposition of: 0 |
(iv) | Shared power to dispose or to direct the disposition of: 0 |
Item 5. | Ownership of Five Percent or Less of a Class. |
If this statement is being filed to report the fact that as of the date hereof the reporting person has ceased to be the beneficial owner of more than 5 percent of the class of securities, check the following ☒
Item 6. | Ownership of More than Five Percent on Behalf of Another Person. |
Not applicable.
Item 7. | Identification and Classification of the Subsidiary Which Acquired the Security Being Reported on By the Parent Holding Company. |
Not applicable.
Item 8. | Identification and Classification of Members of the Group. |
Not applicable.
Item 9. | Notice of Dissolution of Group. |
Not applicable.
Item 10. | Certifications. |
Not applicable.
SIGNATURES
After reasonable inquiry and to the best of the knowledge and belief of the undersigned, the undersigned certify that the information set forth in this statement is true, complete and correct.
Dated February 12, 2021
H&F HARRINGTON AIV II, L.P. | ||
By: Hellman & Friedman Investors VI, L.P., its general partner | ||
By: Hellman & Friedman LLC, its general partner | ||
By: | /s/ Trevor Watt | |
Name: Trevor Watt | ||
Title: Partner | ||
HFCP VI DOMESTIC AIV, L.P. | ||
By: Hellman & Friedman Investors VI, L.P., its general partner | ||
By: Hellman & Friedman LLC, its general partner | ||
By: | /s/ Trevor Watt | |
Name: Trevor Watt | ||
Title: Partner | ||
HELLMAN & FRIEDMAN CAPITAL EXECUTIVES VI, L.P. | ||
By: Hellman & Friedman Investors VI, L.P., its general partner | ||
By: Hellman & Friedman LLC, its general partner | ||
By: | /s/ Trevor Watt | |
Name: Trevor Watt | ||
Title: Partner |
HELLMAN & FRIEDMAN CAPITAL ASSOCIATES VI, L.P. | ||
By: Hellman & Friedman Investors VI, L.P., its general partner | ||
By: Hellman & Friedman LLC, its general partner | ||
By: | /s/ Trevor Watt | |
Name: Trevor Watt | ||
Title: Partner | ||
HELLMAN & FRIEDMAN INVESTORS VI, L.P. | ||
By: Hellman & Friedman LLC, its general partner | ||
By: | /s/ Trevor Watt | |
Name: Trevor Watt | ||
Title: Partner | ||
HELLMAN & FRIEDMAN LLC | ||
By: | /s/ Trevor Watt | |
Name: Trevor Watt | ||
Title: Partner |
EXHIBIT INDEX
Exhibit |
Title | |
1 | Joint Filing Agreement dated February 14, 2020 (incorporated herein by reference to the Exhibit 1 filed with the Schedule 13G filed on February 14, 2020) |