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 |
| |||||||||||||||
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*
(Street)
| 2. Issuer Name and Ticker or Trading Symbol COMPUTER PROGRAMS & SYSTEMS INC [ CPSI ] | 5. Relationship of Reporting Person(s) to Issuer (Check all applicable)
| ||||||||||||||||||||||||
3. Date of Earliest Transaction (Month/Day/Year) 06/12/2017 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed (Month/Day/Year) | 6. Individual or Joint/Group Filing (Check Applicable Line)
|
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 | 06/12/2017 | J(1) | 500,000 | D | $0.00 | 1,465,605(2) | I | See footnote(3) |
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*
(Street)
| ||||||||||||
1. Name and Address of Reporting Person*
(Street)
| ||||||||||||
1. Name and Address of Reporting Person*
(Street)
| ||||||||||||
1. Name and Address of Reporting Person*
(Street)
|
Explanation of Responses: |
1. On June 12, 2017: (a) Francisco Partners II, L.P. ("FP II") made a pro rata distribution for no consideration of 493,224 shares of common stock, par value $0.01, of Computer Programs and Systems, Inc. (the "Shares"), to its partners, including Francisco Partners GP II, L.P. ("FPGP II"); (b) Francisco Partners Parallel Fund II, L.P. ("FPPF II") made a pro rata distribution for no consideration of 6,776 Shares to its partners; and (c) FPGP II made a further pro rata distribution for no consideration of 15,001 Shares to its partners. |
2. Includes 1,445,744 Shares directly held by FP II and 19,861 Shares directly held by FPPF II. |
3. FPGP II is the sole general partner of FP II and FPPF II. Francisco Partners GP II Management, LLC is the sole general partner of FPGP II. |
Remarks: |
Francisco Partners II, L.P., By: Francisco Partners GP II, L.P., its General Partner, By: Francisco Partners GP II Management, LLC, its General Partner, By: /s/ Tom Ludwig, Name: Tom Ludwig, Title: Managing Member | 06/14/2017 | |
Francisco Partners Parallel Fund II, L.P., By: Francisco Partners GP II, L.P., its General Partner, By: Francisco Partners GP II Management, LLC, its General Partner, By: /s/ Tom Ludwig, Name: Tom Ludwig, Title: Managing Member | 06/14/2017 | |
Francisco Partners GP II, L.P., By: Francisco Partners GP II Management, LLC, its General Partner, By: /s/ Tom Ludwig, Name: Tom Ludwig, Title: Managing Member | 06/14/2017 | |
Francisco Partners GP II Management, LLC, By: /s/ Tom Ludwig, Name: Tom Ludwig, Title: Managing Member | 06/14/2017 | |
** 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. |