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
OMB APPROVAL
OMB Number: 3235-0287
Estimated average burden
hours per response: 0.5
X
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*
ORIGINATE GROWTH FUND 1A LP

(Last) (First) (Middle)
205 WEBSTER STREET

(Street)
BETHLEHEM PA 18015

(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)
Director 10% Owner
Officer (give title below) X Other (specify below)
Former 10% owner
3. Date of Earliest Transaction (Month/Day/Year)
12/08/2017
4. If Amendment, Date of Original Filed (Month/Day/Year)
12/12/2017
6. Individual or Joint/Group Filing (Check Applicable Line)
Form filed by One Reporting Person
X 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 12/08/2017 S 237,195 D $25.85(1) 629,594 D(3)
Common Stock 12/11/2017 S 72,625 D $25.85(2) 556,969 D(3)
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
1. Name and Address of Reporting Person*
ORIGINATE GROWTH FUND 1A LP

(Last) (First) (Middle)
205 WEBSTER STREET

(Street)
BETHLEHEM PA 18015

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Originate Growth GP, LLC

(Last) (First) (Middle)
205 WEBSTER STREET

(Street)
BETHLEHEM PA 18015

(City) (State) (Zip)
1. Name and Address of Reporting Person*
BRESSNER GLEN R

(Last) (First) (Middle)
205 WEBSTER STREET

(Street)
BETHLEHEM PA 18015

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Arnson Eric R

(Last) (First) (Middle)
205 WEBSTER STREET

(Street)
BETHLEHEM PA 18015

(City) (State) (Zip)
1. Name and Address of Reporting Person*
GAUSLING MICHAEL J

(Last) (First) (Middle)
205 WEBSTER STREET

(Street)
BETHLEHEM PA 18015

(City) (State) (Zip)
Explanation of Responses:
1. Represents shares of the Company's common stock sold by the Reporting Person in an underwritten public offering completed on December 8, 2017 at a price per share of $25.85, after deducting underwriting discounts and commissions of $1.65 per share.
2. Represents shares of the Company's common stock sold by the Reporting Person upon the exercise of the underwriters' over-allotment option in an underwritten public offering completed on December 11, 2017 at a price per share of $25.85, after deducting underwriting discounts and commissions of $1.65 per share.
3. This report is filed jointly by Originate Growth Fund #1A, L.P. ("Originate #1A"), Originate Growth GP, LLC ("Originate GP"), Glen R. Bressner, Eric R. Arnson and Michael J. Gausling. The shares are held by Originate #1A. The general partner of Originate #1A is Originate GP, a limited liability company. The members of Originate GP are Messrs. Bressner, Arnson and Gausling. The members of Originate GP share voting and dispositive power over the shares held by Originate #1A. Each of these individuals disclaims beneficial ownership of such shares, except to the extent of his pecuniary interest. In addition, 5,565 shares granted to Mr. Bressner in September 2016 and 2,596 shares granted to Mr. Bressner in June 2017 are beneficially owned by Originate Growth Fund #1Q, L.P. and Originate Growth Fund #1A, L.P., with the shares allocated to each fund on a pro rata basis.
Remarks:
Originate Growth Fund #1A, L.P.; By: Originate Growth GP, LLC; By: /s/ Glen Bressner, Managing Partner 03/13/2018
Originate Growth GP, LLC; By: /s/ Glen Bressner, Managing Partner 03/13/2018
/s/ Glen R. Bressner 03/13/2018
/s/ Eric R. Arnson 03/13/2018
/s/ Michael J. Gausling 03/13/2018
** 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).
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.