SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

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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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
Knowlton Orsula V

(Last) (First) (Middle)
228 STRAWBRIDGE DRIVE
SUITE 100

(Street)
MOORESTOWN NJ 08057

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
Tabula Rasa HealthCare, Inc. [ TRHC ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director X 10% Owner
X Officer (give title below) Other (specify below)
President
3. Date of Earliest Transaction (Month/Day/Year)
01/26/2017
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 01/26/2017 M 939 A $1.71 739,998 D
Common Stock 01/26/2017 M 5,809 A $2.35 745,807 D
Common Stock 01/26/2017 M 25,773 A $3.42 771,580 D
Common Stock 01/26/2017 M 3,524 A $3.42 775,104 D
Common Stock 01/26/2017 M 257,061 A $3.42 1,032,165 D
Common Stock 01/26/2017 M 3,261 A $6.41 1,035,426 D
Common Stock 01/26/2017 M 27,062 A $6.41 1,062,488 D
Common Stock 01/26/2017 M 18,041 A $6.41 1,080,529 D
Common Stock 01/26/2017 M 1,662 A $6.41 1,082,191 D
Common Stock 01/26/2017 F 158,310 D $14.53 923,881 D
Common Stock 01/26/2017 M 1,015 A $1.71 725,393 I Held by spouse.
Common Stock 01/26/2017 M 6,280 A $2.35 731,673 I Held by spouse.
Common Stock 01/26/2017 M 25,773 A $3.42 757,446 I Held by spouse.
Common Stock 01/26/2017 M 3,810 A $3.42 761,256 I Held by spouse.
Common Stock 01/26/2017 M 257,061 A $3.42 1,018,317 I Held by spouse.
Common Stock 01/26/2017 M 4,245 A $6.41 1,022,571 I Held by spouse.
Common Stock 01/26/2017 M 27,062 A $6.41 1,049,633 I Held by spouse.
Common Stock 01/26/2017 M 18,041 A $6.41 1,067,674 I Held by spouse.
Common Stock 01/26/2017 M 1,860 A $6.41 1,069,534 I Held by spouse.
Common Stock 01/26/2017 F 158,988 D $14.53 910,546 I Held by spouse.
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Employee Stock Option (right to buy) $1.71 01/26/2017 M 939 03/01/2012 03/01/2017 Common Stock 939 $0 0 D
Employee Stock Option (right to buy) $2.35 01/26/2017 M 5,809 12/20/2012 12/20/2017 Common Stock 5,809 $0 0 D
Employee Stock Option (right to buy) $3.42 01/26/2017 M 25,773 (1) 01/02/2018 Common Stock 25,773 $0 0 D
Employee Stock Option (right to buy) $3.42 01/26/2017 M 3,524 01/22/2013 01/22/2018 Common Stock 3,524 $0 0 D
Employee Stock Option (right to buy) $3.42 01/26/2017 M 257,061 (2) 06/28/2018 Common Stock 257,061 $0 36,723 D
Employee Stock Option (right to buy) $6.41 01/26/2017 M 3,261 01/01/2014 01/01/2019 Common Stock 3,261 $0 0 D
Employee Stock Option (right to buy) $6.41 01/26/2017 M 27,062 (3) 01/01/2019 Common Stock 27,062 $0 9,020 D
Employee Stock Option (right to buy) $6.41 01/26/2017 M 18,041 (4) 01/01/2020 Common Stock 18,041 $0 18,041 D
Employee Stock Option (right to buy) $6.41 01/26/2017 M 1,662 02/01/2015 02/01/2020 Common Stock 1,662 $0 0 D
Employee Stock Option (right to buy) $1.71 01/26/2017 M 1,015 03/01/2012 03/01/2017 Common Stock 1,015 $0 0 I Held by spouse.
Employee Stock Option (right to buy) $2.35 01/26/2017 M 6,280 12/20/2012 12/20/2017 Common Stock 6,280 $0 0 I Held by spouse.
Employee Stock Option (right to buy) $3.42 01/26/2017 M 25,773 (5) 01/02/2018 Common Stock 25,773 $0 0 I Held by spouse.
Employee Stock Option (right to buy) $3.42 01/26/2017 M 3,810 01/22/2013 01/22/2018 Common Stock 3,810 $0 0 I Held by spouse.
Employee Stock Option (right to buy) $3.42 01/26/2017 M 257,061 (6) 06/28/2018 Common Stock 257,061 $0 36,723 I Held by spouse.
Employee Stock Option (right to buy) $6.41 01/26/2017 M 4,254 01/01/2014 01/01/2019 Common Stock 4,254 $0 0 I Held by spouse.
Employee Stock Option (right to buy) $6.41 01/26/2017 M 27,062 (7) 01/01/2019 Common Stock 27,062 $0 9,020 I Held by spouse.
Employee Stock Option (right to buy) $6.41 01/26/2017 M 18,041 (8) 01/01/2020 Common Stock 18,041 $0 18,041 I Held by spouse.
Employee Stock Option (right to buy) $6.41 01/26/2017 M 1,860 02/01/2015 02/01/2020 Common Stock 1,860 $0 0 I Held by spouse.
Explanation of Responses:
1. The Stock Option vests 25% on January 2, 2014 and in equal 1/36th installments each month thereafter.
2. The Stock Option vests 25% on June 28, 2014 and in equal 1/36th installments each month thereafter.
3. The Stock Option vests 25% on January 1, 2015 and in equal 1/36th installments each month thereafter.
4. The Stock Option vests 25% on January 1, 2016 and in equal 1/36th installments each month thereafter.
5. The Stock Option vests 25% on January 2, 2014 and in equal 1/36th installments each month thereafter.
6. The Stock Option vests 25% on June 28, 2014 and in equal 1/36th installments each month thereafter.
7. The Stock Option vests 25% on January 1, 2015 and in equal 1/36th installments each month thereafter.
8. The Stock Option vests 25% on January 1, 2016 and in equal 1/36th installments each month thereafter.
/s/ Brian W. Adams, by Power of Attorney previously filed 01/30/2017
** 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 4 (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).
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