0001213900-16-017114.txt : 20160928 0001213900-16-017114.hdr.sgml : 20160928 20160928191554 ACCESSION NUMBER: 0001213900-16-017114 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20160928 FILED AS OF DATE: 20160928 DATE AS OF CHANGE: 20160928 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Tabula Rasa HealthCare, Inc. CENTRAL INDEX KEY: 0001651561 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-BUSINESS SERVICES, NEC [7389] IRS NUMBER: 465726437 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 228 STRAWBRIDGE DRIVE STREET 2: SUITE 100 CITY: MOORESTOWN STATE: NJ ZIP: 08057 BUSINESS PHONE: 866-648-2767 MAIL ADDRESS: STREET 1: 228 STRAWBRIDGE DRIVE STREET 2: SUITE 100 CITY: MOORESTOWN STATE: NJ ZIP: 08057 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Durham Joann M. CENTRAL INDEX KEY: 0001685517 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37888 FILM NUMBER: 161908078 MAIL ADDRESS: STREET 1: 3 BARTRAM COURT CITY: MOORESTOWN STATE: NJ ZIP: 08057 3 1 f3092816joann_tabularasa.xml OWNERSHIP DOCUMENT X0206 3 2016-09-28 0 0001651561 Tabula Rasa HealthCare, Inc. TRHC 0001685517 Durham Joann M. 3 BARTRAM COURT MOORESTOWN NJ 08057 0 0 1 0 Common Stock 803425 I By husband Warrant (Common Stock) 0.48 2009-05-01 2019-05-01 Common Stock 12886 D Warrant (Common Stock) 0.48 2009-05-01 2019-05-01 Common Stock 7731 I By husband Warrant (Common Stock) 3.10 2013-05-15 2023-05-15 Common Stock 264 D Warrant (Common Stock) 3.10 2013-06-15 2023-06-15 Common Stock 660 D Warrant (Common Stock) 3.10 2013-07-15 2023-07-15 Common Stock 684 D Warrant (Common Stock) 3.10 2013-08-15 2023-08-15 Common Stock 684 D Warrant (Common Stock) 3.10 2013-09-15 2023-09-15 Common Stock 661 D Warrant (Common Stock) 3.10 2013-10-15 2023-10-15 Common Stock 684 D Warrant (Common Stock) 3.10 2013-11-15 2023-11-15 Common Stock 661 D Warrant (Common Stock) 3.10 2013-12-15 2023-12-15 Common Stock 684 D Warrant (Common Stock) 5.82 2014-01-15 2024-01-15 Common Stock 364 D Warrant (Common Stock) 5.82 2014-02-15 2024-02-15 Common Stock 329 D Warrant (Common Stock) 5.82 2014-03-15 2024-03-15 Common Stock 364 D Warrant (Common Stock) 5.82 2014-04-15 2024-04-15 Common Stock 353 D Warrant (Common Stock) 5.82 2014-05-15 2024-05-15 Common Stock 364 D Warrant (Common Stock) 5.82 2014-06-15 2024-06-15 Common Stock 353 D Warrant (Common Stock) 5.82 2014-07-15 2024-07-15 Common Stock 364 D Warrant (Common Stock) 5.82 2014-08-15 2024-08-15 Common Stock 364 D Warrant (Common Stock) 5.82 2014-09-15 2024-09-15 Common Stock 353 D Warrant (Common Stock) 5.82 2014-10-15 2024-10-15 Common Stock 364 D Warrant (Common Stock) 5.82 2014-11-15 2024-11-15 Common Stock 353 D Warrant (Common Stock) 5.82 2014-12-15 2024-12-15 Common Stock 90 D Warrants expire on the earlier of the date stated or the date of the closing of the Issuer's initial public offering. /s/ Joann M. Durham 2016-09-28