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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
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 control number. | SEC 1474 (9-02) |
1. Title of Derivative Security (Instr. 3) |
2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction 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 (Month/Day/Year) |
7. Title and Amount of Underlying Securities (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) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
CLINE J MICHAEL C/O ACCRETIVE HEALTH, INC. 401 NORTH MICHIGAN AVENUE, SUITE 2700 CHICAGO, IL 60611 |
X | X |
/s/ J. Michael Cline | 11/15/2011 | |
**Signature of Reporting Person | Date |
* | 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). |
(1) | Represents shares of common stock beneficially owned by JMC Holdings, L.P., of which the Reporting Person is the general partner. The Reporting Person and JMC Holdings, L.P. disclaim beneficial ownership within the meaning of Section 16 of the Securities Exchange Act of 1934, as amended, or otherwise of such portion of the common stock in which such persons have no actual pecuniary interest. Includes 7,266,016 shares of common stock that were received by JMC Holdings, L.P. as part of a pro rata distribution from Accretive Investors SBIC, L.P. ("Accretive Investors") to its partners. In prior reports, the Reporting Person reported indirect beneficial ownership of the shares of common stock held by Accretive Investors. |
(2) | Represents shares of common stock beneficially owned by Accretive Associates SBIC, LLC, of which the Reporting Person is the managing member. The Reporting Person disclaims beneficial ownership within the meaning of Section 16 of the Securities Exchange Act of 1934, as amended, or otherwise of such portion of the Accretive Associates SBIC, LLC shares in which the Reporting Person has no actual pecuniary interest. Includes 35,143 shares of common stock that were received by Accretive Associates SBIC, LLC as part of a pro rata distribution from Accretive Investors to its partners. In prior reports, the Reporting Person reported indirect beneficial ownership of the shares of common stock held by Accretive Investors. |
(3) | These shares of common stock were received by the Reporting Person as part of a pro rata distribution from Accretive Investors to its partners. In prior reports, the Reporting Person reported indirect beneficial ownership of the shares of common stock held by Accretive Investors. |