SEC FORM 4 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
 
OMB APPROVAL
OMB Number: 3235-0287
Estimated average burden
hours per response: 0.5
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
Pamplona Capital Partners III, L.P.

(Last) (First) (Middle)
C/O PAMPLONA CAPITAL MANAGEMENT LLC
667 MADISON AVENUE, 22 FLOOR

(Street)
NEW YORK NY 10065

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
Privia Health Group, Inc. [ PRVA ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director X 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
04/04/2022
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
Form filed by One Reporting Person
X Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 04/04/2022 J(2) 4,804,754 D (2) 15,215,054 I See Footnotes(1)(3)(4)
Common Stock 04/04/2022 J(2) 4,804,754 A (2) 20,019,808 I See Footnotes(1)(3)(4)
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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 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: 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
1. Name and Address of Reporting Person*
Pamplona Capital Partners III, L.P.

(Last) (First) (Middle)
C/O PAMPLONA CAPITAL MANAGEMENT LLC
667 MADISON AVENUE, 22 FLOOR

(Street)
NEW YORK NY 10065

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Pamplona Equity Advisors III Ltd

(Last) (First) (Middle)
C/O PAMPLONA CAPITAL MANAGEMENT, LLC
667 MADISON AVENUE, 22ND FLOOR

(Street)
NEW YORK NY 10065

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Pamplona Equity Carryco Advisors III, Ltd.

(Last) (First) (Middle)
C/O PAMPLONA CAPITAL MANAGEMENT LLC
667 MADISON AVENUE, 22ND FLOOR

(Street)
NEW YORK NY 10065

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Pamplona PE Investments Malta Ltd

(Last) (First) (Middle)
C/O PAMPLONA CAPITAL MANAGEMENT LLC
667 MADISON AVENUE, 22 FLOOR

(Street)
NEW YORK NY 10065

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Pamplona Capital Management, LLP

(Last) (First) (Middle)
C/O PAMPLONA CAPITAL MANAGEMENT LLC
667 MADISON AVENUE, 22 FLOOR

(Street)
NEW YORK NY 10065

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Pamplona Capital Management, LLC

(Last) (First) (Middle)
C/O PAMPLONA CAPITAL MANAGEMENT LLC
667 MADISON AVENUE, 22 FLOOR

(Street)
NEW YORK NY 10065

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Halsted John C.

(Last) (First) (Middle)
C/O PAMPLONA CAPITAL MANAGEMENT LLC
667 MADISON AVENUE, 22ND FLOOR

(Street)
NEW YORK NY 10065

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Knaster Alexander M

(Last) (First) (Middle)
C/O PAMPLONA CAPITAL MANAGEMENT LLC
667 MADISON AVENUE, 22 FLOOR

(Street)
NEW YORK NY 10065

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Pamplona Private Equity Carryco III, L.P.

(Last) (First) (Middle)
C/O PAMPLONA CAPITAL MANAGEMENT LLC
667 MADISON AVENUE, 22ND FLOOR

(Street)
NEW YORK NY 10065

(City) (State) (Zip)
Explanation of Responses:
1. This statement is being filed by (i) Pamplona Capital Partners III, L.P. ("PCP III") (ii) Pamplona Equity Advisors III Ltd., (iii) Pamplona Private Equity Carryco III, L.P. ("PPEC"), (iv) Pamplona Equity Carryco III, Ltd., (v) Pamplona PE Investments Malta Limited, (vi) Pamplona Capital Management LLP, (vii) Pamplona Capital Management LLC, (viii) John C. Halsted and (ix) Alexander Knaster (the foregoing, collectively, the "Reporting Persons").
2. Represents a cross-trade, pursuant to which PCP III transferred 4,804,754 shares of common stock, par value $0.01 per share (the "Common Stock") of Privia Health Group, Inc. to PPEC for no monetary consideration.
3. The shares of Common Stock are held by PCP III and PPEC. PCP III is controlled by Pamplona Equity Advisors III Ltd., its general partner. John C. Halsted owns 100% of the shares of Pamplona Equity Advisors III, Ltd. Pamplona PE Investments Malta Limited serves as an investment manager to PCP III. Pamplona Capital Management LLP and Pamplona Capital Management LLC (together, the "Pamplona Manager Entities") serve as investment advisors to Pamplona PE Investments Malta Limited. Mr. John C. Halsted and Mr. Alexander Knaster are the principals of the Pamplona Manager Entities. PPEC is controlled by Pamplona Equity Carryco III, Ltd., its general partner. Mr. Alexander Knaster owns 100% of the shares of Pamplona Equity Carryco III, Ltd.
4. Each Reporting Person disclaims beneficial ownership of the securities reported herein except to the extent of its pecuniary interest therein, if any, and this report shall not be deemed an admission that any such person or entity is the beneficial owner of, or has any pecuniary interest in, such securities for purposes of Section 16 of the Securities Exchange Act of 1934, as amended, or for any other purpose.
Ronan Guilfoyle, Director, PAMPLONA EQUITY ADVISORS III LTD 04/06/2022
Ronan Guilfoyle, Director, Pamplona Equity Advisors III Ltd., the General Partner of PAMPLONA CAPITAL PARTNERS III, L.P. 04/06/2022
Ronan Guilfoyle, Director, PAMPLONA EQUITY CARRYCO ADVISORS III, LTD. 04/06/2022
Ronan Guilfoyle, Director, PAMPLONA EQUITY CARRYCO ADVISORS III, LTD. 04/06/2022
Stephen Gauci, Director, PAMPLONA PE INVESTMENTS MALTA LIMITED 04/06/2022
Kevin O'Flaherty, Designated Member, PAMPLONA CAPITAL MANAGEMENT LLP 04/06/2022
Stephen Gauci, Managing Member, PAMPLONA CAPITAL MANAGEMENT LLC 04/06/2022
John C. Halsted 04/06/2022
Alexander Knaster 04/06/2022
** 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.