0001209191-15-004218.txt : 20150114 0001209191-15-004218.hdr.sgml : 20150114 20150114172816 ACCESSION NUMBER: 0001209191-15-004218 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20150112 FILED AS OF DATE: 20150114 DATE AS OF CHANGE: 20150114 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Burlington Stores, Inc. CENTRAL INDEX KEY: 0001579298 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-DEPARTMENT STORES [5311] IRS NUMBER: 800895227 STATE OF INCORPORATION: DE FISCAL YEAR END: 0201 BUSINESS ADDRESS: STREET 1: 2006 ROUTE 130 NORTH CITY: FLORENCE STATE: NJ ZIP: 08518 BUSINESS PHONE: (609) 387-7800 MAIL ADDRESS: STREET 1: 2006 ROUTE 130 NORTH CITY: FLORENCE STATE: NJ ZIP: 08518 FORMER COMPANY: FORMER CONFORMED NAME: Burlington Holdings, Inc. DATE OF NAME CHANGE: 20130613 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Patrick Tricia CENTRAL INDEX KEY: 0001585849 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36107 FILM NUMBER: 15527918 MAIL ADDRESS: STREET 1: C/O BAIN CAPITAL PARTNERS, LLC STREET 2: JOHN HANCOCK TOWER, 200 CLARENDON ST CITY: BOSTON STATE: MA ZIP: 02116 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2015-01-12 0 0001579298 Burlington Stores, Inc. BURL 0001585849 Patrick Tricia C/O BAIN CAPITAL INVESTORS, LLC JOHN HANCOCK TOWER, 200 CLARENDON STREET BOSTON MA 02116 1 0 1 0 Common Stock 2015-01-12 4 J 0 1200360 0.00 D 23789794 I See Footnotes Bain Capital Investors, LLC ("BCI") is the sole general partner of Bain Capital Partners IX, L.P., which is the sole general partner of Bain Capital Fund IX, L.P., which is the sole member Bain Capital Fund IX, LLC ("Fund IX"). BCI is also the administrative member of Bain Capital Integral Investors, LLC ("Integral") and BCIP TCV, LLC ("BCIP TCV"). BCI is also the managing partner of BCIP Associates-G ("BCIP G" and together with the Fund IX, Integral and BCIP TCV, the "Bain Entities"). Tricia Patrick is a Principal of BCI. By virtue of the relationships described in these footnotes, Ms. Patrick may be deemed to share voting and dispositive power with respect to the shares of Common Stock held by Bain Entities. Ms. Patrick disclaims beneficial ownership of such securities except to the extent of her pecuniary interest therein. On January 12, 2015, the Bain Entities distributed 1,200,360 shares of Common Stock to one or more members or partners of the Bain Entities in connection with certain charitable gifts made by such members or partners on January 12, 2015. /s/ Tricia Patrick 2015-01-14