UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549INITIAL STATEMENT OF 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. | SEC 1473 (7-02) | ||
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. |
1. Title of Derivative Security (Instr. 4) |
2. Date Exercisable and Expiration Date (Month/Day/Year) |
3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) |
4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 5) |
6. Nature of Indirect Beneficial Ownership (Instr. 5) |
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Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
WAUD CAPITAL PARTNERS III, L.L.C. WAUD CAPITAL PARTNERS, LLC 300 N. LASALLE STREET, SUITE 4900 CHICAGO, IL 60654 |
 |  X |  |  |
WAUD CAPITAL PARTNERS MANAGEMENT III, L.P. WAUD CAPITAL PARTNERS, LLC 300 N. LASALLE STREET, SUITE 4900 CHICAGO, IL 60654 |
 |  X |  |  |
WAUD CAPITAL PARTNERS III, L.P. WAUD CAPITAL PARTNERS, LLC 300 N. LASALLE STREET, SUITE 4900 CHICAGO, IL 60654 |
 |  X |  |  |
WAUD CAPITAL PARTNERS QP III, L.P. WAUD CAPITAL PARTNERS, LLC 300 N. LASALLE STREET, SUITE 4900 CHICAGO, IL 60654 |
 |  X |  |  |
WCP FIF III (ACADIA), L.P. WAUD CAPITAL PARTNERS, LLC 300 N. LASALLE STREET, SUITE 4900 CHICAGO, IL 60654 |
 |  X |  |  |
WAUD CAPITAL AFFILIATES III, L.L.C. WAUD CAPITAL PARTNERS, LLC 300 N. LASALLE STREET, SUITE 4900 CHICAGO, IL 60654 |
 |  X |  |  |
Waud Capital Parters III, L.L.C., by /s/ Reeve B. Waud, its manager | 10/31/2011 | |
**Signature of Reporting Person | Date | |
Waud Capital Partners Management III, L.P., by Waud Capital Partners III, L.L.C., its general partner, by /s/ Reeve B. Waud, its manager | 10/31/2011 | |
**Signature of Reporting Person | Date | |
Waud Capital Partners III, L.P., by Waud Capital Partners Management III, L.P., its general partner, by Waud Capital Partners III, L.L.C., its general partner, by /s/ Reeve B. Waud, its manager | 10/31/2011 | |
**Signature of Reporting Person | Date | |
Waud Capital Partners QP III, L.P., by Waud Capital Partners Management III, L.P., its general partner, by Waud Capital Partners III, L.L.C., its general partner, by /s/ Reeve B. Waud, its manager | 10/31/2011 | |
**Signature of Reporting Person | Date | |
WCP FIF III (Acadia), L.P., by Waud Capital Partners Management III, L.P., its general partner, by Waud Capital Partners III, L.L.C., its general partner, by /s/ Reeve B. Waud, its manager | 10/31/2011 | |
**Signature of Reporting Person | Date | |
Waud Capital Partners Affiliates III, LLC., by Waud Capital Partners Management III, L.P., its general partner, by Waud Capital Partners III, L.L.C., its general partner, by /s/ Reeve B. Waud, its manager | 10/31/2011 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 5(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) | Reeve B. Waud is a member of the board of managers of Acadia Healthcare Holdings, LLC ("Holdings"). Mr. Waud is also the manager of Waud Capital Partners III, L.L.C. ("Waud III LLC") and a member of the limited partner committee of Waud Capital Partners Management III, L.P. ("WCPM III"). Waud III LLC is the general partner of WCPM III. WCPM III is the general partner of Waud Capital Partners III, L.P. ("WCP III"), Waud Capital Partners QP III, L.P. ("Waud QP III") and WCP FIF III (Acadia), L.P. ("WCP FIF III"). WCPM III is also the manager of Waud Capital Affiliates III, L.L.C. ("Waud Affiliates III"). As a result each of Waud III LLC, WCPM III, WCP III, Waud QP III, WCP FIF III and Waud Affiliates III may be deemed to share beneficial ownership of the reported securities. |
(2) | Holdings will distribute shares of Acadia Healthcare Company, Inc. common stock to its members, which include certain of the reporting persons, in respect of their ownership interests prior to the merger of Acadia Healthcare Company, Inc. and PHC, Inc. After such distribution, the reported shares will be owned of record as follows: (i) 424,848 shares by WCP III; (ii) 2,402,453 shares by Waud QP III; (iii)1,054,368 shares by WCP FIF III; and (iv) 388,167 shares by Waud Affiliates III. |
(3) | Each of the reporting persons expressly disclaims beneficial ownership of the reported securities except to the extent of its pecuniary interest therein. |
 Remarks: The reporting persons set forth are members of a "group" with the Reeve B. Waud 2011 Family Trust, Waud Family Partners, L.P., Waud Capital Partners II, L.L.C., Waud Capital Partners Management II, L.P., Waud Capital Partners II, L.P., Waud Capital Partners QP II, L.P., WCP FIF II (Acadia), L.P., and Waud Capital Affiliates II, L.L.C.  The Form 3's for such other entities are filed separately. |