0001104659-17-005814.txt : 20170201 0001104659-17-005814.hdr.sgml : 20170201 20170201162901 ACCESSION NUMBER: 0001104659-17-005814 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170131 FILED AS OF DATE: 20170201 DATE AS OF CHANGE: 20170201 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Affinity Gaming CENTRAL INDEX KEY: 0001499268 STANDARD INDUSTRIAL CLASSIFICATION: HOTELS & MOTELS [7011] IRS NUMBER: 020815199 STATE OF INCORPORATION: NV FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 3755 BREAKTHROUGH WAY STREET 2: SUITE 300 CITY: LAS VEGAS STATE: NV ZIP: 89135 BUSINESS PHONE: (702) 341-2400 MAIL ADDRESS: STREET 1: 3755 BREAKTHROUGH WAY STREET 2: SUITE 300 CITY: LAS VEGAS STATE: NV ZIP: 89135 FORMER COMPANY: FORMER CONFORMED NAME: Affinity Gaming, LLC DATE OF NAME CHANGE: 20110630 FORMER COMPANY: FORMER CONFORMED NAME: Herbst Gaming, LLC DATE OF NAME CHANGE: 20100816 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Tanjeloff Eric CENTRAL INDEX KEY: 0001577384 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-54085 FILM NUMBER: 17565268 MAIL ADDRESS: STREET 1: C/O AFFINITY GAMING STREET 2: 3755 BREAKTHROUGH WAY, SUITE 300 CITY: LAS VEGAS STATE: NV ZIP: 89135 4 1 a4.xml 4 X0306 4 2017-01-31 1 0001499268 Affinity Gaming NONE 0001577384 Tanjeloff Eric C/O AFFINITY GAMING 3755 BREAKTHROUGH WAY, SUITE 300 LAS VEGAS NV 89135 1 0 0 0 Common Stock 2017-01-31 4 D 0 28061 17.35 D 0 D Pursuant to the Agreement and Plan of Merger, dated as of August 22, 2016, among Z Capital Affinity Owner, LLC ("Parent"), Affinity Merger Sub, Inc. and Affinity Gaming (the "Merger Agreement"), at the effective time of the merger of Affinity Merger Sub, Inc. with and into Affinity Gaming (the "Merger") each share of Affinity Gaming common stock converted into the right to receive $17.35 in cash. The Merger is more completely described in the Company's Definitive Proxy Statement filed with the SEC on November 14, 2016. Includes shares of restricted stock. Pursuant to the Merger Agreement, each restricted stock award outstanding immediately prior to the effective time of the Merger was converted into the right to receive an amount in cash equal to the product of (i) $17.35 and (ii) the number of shares of Affinity Gaming common stock subject to such award. /s/ Marc H. Rubinstein, as Attorney-in-Fact for Eric Tanjeloff 2017-02-01