0000947871-17-000901.txt : 20171109 0000947871-17-000901.hdr.sgml : 20171109 20171109172243 ACCESSION NUMBER: 0000947871-17-000901 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20171108 FILED AS OF DATE: 20171109 DATE AS OF CHANGE: 20171109 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Burke Richard L. Jr. CENTRAL INDEX KEY: 0001657563 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37904 FILM NUMBER: 171192008 MAIL ADDRESS: STREET 1: 90 FORT WADE ROAD CITY: PONTE VEDRA STATE: FL ZIP: 32081 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Advanced Disposal Services, Inc. CENTRAL INDEX KEY: 0001585790 STANDARD INDUSTRIAL CLASSIFICATION: REFUSE SYSTEMS [4953] IRS NUMBER: 900875845 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 90 FORT WADE ROAD - SUITE 200 CITY: PONTE VEDRA STATE: FL ZIP: 32081 BUSINESS PHONE: 904-737-7900 MAIL ADDRESS: STREET 1: 90 FORT WADE ROAD - SUITE 200 CITY: PONTE VEDRA STATE: FL ZIP: 32081 FORMER COMPANY: FORMER CONFORMED NAME: ADS Waste Holdings, Inc. DATE OF NAME CHANGE: 20130904 4 1 ss66841_4.xml OWNERSHIP DOCUMENT X0306 4 2017-11-08 0 0001585790 Advanced Disposal Services, Inc. ADSW 0001657563 Burke Richard L. Jr. C/O ADVANCED DISPOSAL SERVICES, INC., 90 FORT WADE ROAD PONTE VEDRA FL 32081 1 1 0 0 Chief Exec. Officer & Director Common Stock 2017-11-08 4 M 0 9040 17.70 A 227227 D Employee Stock Option (right to buy) 17.70 2017-11-08 4 M 0 9040 0 D 2022-11-20 Common Stock 9040 429203 D The Reporting Person paid cash for the entire value of the strike price for the option exercise. This option fully vested in connection with its grant upon the Reporting Person's appointment as the Issuer's Chief Executive Office. /s/ Jeffrey Everett, Attorney-in-Fact for Richard L. Burke. Jr 2017-11-09