0001140361-17-029155.txt : 20170728 0001140361-17-029155.hdr.sgml : 20170728 20170728163025 ACCESSION NUMBER: 0001140361-17-029155 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20170728 DATE AS OF CHANGE: 20170728 EFFECTIVENESS DATE: 20170728 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Cotiviti Holdings, Inc. CENTRAL INDEX KEY: 0001657197 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-BUSINESS SERVICES, NEC [7389] IRS NUMBER: 460595918 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-291742 FILM NUMBER: 17990411 BUSINESS ADDRESS: STREET 1: 115 PERIMETER CENTER PLACE STREET 2: SUITE 700 CITY: ATLANTA STATE: GA ZIP: 30346 BUSINESS PHONE: 770 379-2800 MAIL ADDRESS: STREET 1: 115 PERIMETER CENTER PLACE STREET 2: SUITE 700 CITY: ATLANTA STATE: GA ZIP: 30346 D 1 primary_doc.xml X0708 D LIVE 0001657197 Cotiviti Holdings, Inc. The South Terraces, Suite 700 115 Perimeter Center Place Atlanta GA GEORGIA 30346 (770) 379-2800 DELAWARE None None Corporation true J. Douglas William The South Terraces, Suite 700 115 Perimeter Center Place Atlanta GA GEORGIA 30346 Executive Officer Director David Beaulieu The South Terraces, Suite 700 115 Perimeter Center Place Atlanta GA GEORGIA 30346 Executive Officer Steve Senneff The South Terraces, Suite 700 115 Perimeter Center Place Atlanta GA GEORGIA 30346 Executive Officer Jonathan Olefson The South Terraces, Suite 700 115 Perimeter Center Place Atlanta GA GEORGIA 30346 Executive Officer David L. Swift The South Terraces, Suite 700 115 Perimeter Center Place Atlanta GA GEORGIA 30346 Director Kenneth R. Goulet The South Terraces, Suite 700 115 Perimeter Center Place Atlanta GA GEORGIA 30346 Director Ruben Jose King-Shaw, Jr. The South Terraces, Suite 700 115 Perimeter Center Place Atlanta GA GEORGIA 30346 Director James E. Parisi The South Terraces, Suite 700 115 Perimeter Center Place Atlanta GA GEORGIA 30346 Director Elizabeth Connolly Alexander The South Terraces, Suite 700 115 Perimeter Center Place Atlanta GA GEORGIA 30346 Director Mala Anand The South Terraces, Suite 700 115 Perimeter Center Place Atlanta GA GEORGIA 30346 Director John Maldonado The South Terraces, Suite 700 115 Perimeter Center Place Atlanta GA GEORGIA 30346 Director Christopher C. Pike The South Terraces, Suite 700 115 Perimeter Center Place Atlanta GA GEORGIA 30346 Director Other Decline to Disclose 06b false 2017-07-14 false true true true 0 30000000 30000000 0 true 6 16 0 0 0 false Cotiviti Holdings, Inc. /s/ Jonathan Olefson Jonathan Olefson General Counsel 2017-07-27