Statement of Changes in Beneficial Ownership (4)
June 23 2021 - 6:03PM
Edgar (US Regulatory)
FORM 4
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
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YALE PHYLLIS R |
2. Issuer Name and Ticker or Trading Symbol
DAVITA INC.
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DVA
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director _____ 10% Owner _____ Officer (give title below) _____ Other (specify below)
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(Last)
(First)
(Middle)
C/O DAVITA INC, 2000 16TH STREET |
3. Date of Earliest Transaction
(MM/DD/YYYY)
6/22/2021 |
(Street)
DENVER, CO 80202
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
_X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security (Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code (Instr. 8)
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4. Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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Common Stock | 6/22/2021 | | M | | 4579 | A | $78.44 | 14125 | D | |
Common Stock | 6/22/2021 | | D | | 2889 (1) | D | $124.36 | 11236 | D | |
Common Stock | 6/22/2021 | | M | | 7178 | A | $66.17 | 18414 | D | |
Common Stock | 6/22/2021 | | D | | 3820 (1) | D | $124.36 | 14594 | D | |
Common Stock | 6/22/2021 | | S | | 5048 | D | $124.3266 (2) | 9546 | D | |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Trans. Date | 3A. Deemed Execution Date, if any | 4. Trans. 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 | 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 of Derivative Security: 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 |
Stock Appreciation Rights | $78.44 | 6/22/2021 | | M | | | 4579 | 6/20/2017 (3) | 7/11/2021 | Common Stock | 4579.0 | $0 | 0 | D | |
Stock Appreciation Rights | $66.17 (4) | 6/22/2021 | | M | | | 7178 | 6/16/2018 (5) | 6/16/2022 | Common Stock | 7178.0 | $0 | 0 | D | |
Explanation of Responses: |
(1) | Represents the shares withheld in payment of the base price in connection with the exercise of Stock Appreciation Rights reported on this Form 4. |
(2) | Represents the weighted average sale price of $124.3266. The range of prices for the sale of these shares was $124.311 - $124.431 rounded to the nearest thousandths. The reporting person undertakes to provide upon request by the Commission staff, the Issuer, or a security holder of the Issuer, full information regarding the number of shares sold at each separate price. |
(3) | The Stock Appreciation Rights were granted on July 11, 2016. 100% vested on June 20, 2017. |
(4) | Price previously reported as $13.234 on Form 4 filed on June 20, 2017. |
(5) | The Stock Appreciation Rights were granted on June 16, 2017. 100% vested on June 16, 2018. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
YALE PHYLLIS R C/O DAVITA INC 2000 16TH STREET DENVER, CO 80202 | X |
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Signatures
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/s/ Stephanie Berberich, Attorney-in-Fact | | 6/23/2021 |
**Signature of Reporting Person | Date |
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