FORM 3 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES 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*
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 10/05/2016 |
3. Issuer Name and Ticker or Trading Symbol
Advanced Disposal Services, Inc. [ ADSW ] |
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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5. If Amendment, Date of Original Filed
(Month/Day/Year) |
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6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Beneficially Owned | |||
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1. Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
Common Stock | 1,000 | I | See Footnotes(1)(2)(3) |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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1. Title of Derivative Security (Instr. 4) | 2. Date Exercisable and Expiration Date (Month/Day/Year) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 6. Nature of Indirect Beneficial Ownership (Instr. 5) | ||
Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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Explanation of Responses: |
1. This Form 3 is filed jointly by Highstar Capital LP ("Highstar"), Star Atlantic GP, Inc. and Star Atlantic Waste Holdings, L.P. ("Star Atlantic"). Highstar is a registered investment adviser. PineBridge Highstar (SPE) LLC serves as the general partner of Star Atlantic GP Inc. and has delegated management authority for Star Atlantic GP, Inc. to Highstar. |
2. Highstar also serves as the investment manager for Star Atlantic. Star Atlantic GP, Inc. is the general partner of Star Atlantic Waste Holdings II, L.P., the controlling shareholder of Advanced Disposal Waste Holdings Corp. ("Advanced Disposal") which holds of record all of the outstanding shares of common stock of the Issuer (the "Shares"). |
3. By virtue of the foregoing relationships, each of the Reporting Persons may be deemed to have voting and investment power over the Shares held of record by Advanced Disposal and as a result may be deemed to have beneficial ownership of such Shares for purposes of Rule 13d-3 under the Securities Exchange Act of 1934, as amended (the "Exchange Act") . Each of the Reporting Persons disclaims beneficial ownership of the securities reported herein for purposes of Rule 16a-1(a) under the Exchange Act except to the extent of its pecuniary interest therein. Highstar is controlled by Christopher Lee, Michael Miller, John Stokers, Christopher Beall and Scott Litman. These individuals expressly disclaim beneficial ownership of any of the Shares held of record by Advanced Disposal. This report shall not be deemed an admission that the Reporting Persons or any other person named herein is a beneficial owner for purposes of Section 16 of the Exchange Act or for any other purpose. |
Remarks: |
/s/ Christopher Beall, as Executive Vice President of Highstar Capital LP | 10/05/2016 | |
/s/ Christopher Beall, as Vice President of Star Atlantic GP Inc. Inc. | 10/05/2016 | |
/s/ Christopher Beall, as Vice President of Star Atlantic Waste Holdings, L.P. | 10/05/2016 | |
** 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 5 (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. |