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