0000899243-21-023413.txt : 20210611 0000899243-21-023413.hdr.sgml : 20210611 20210611205854 ACCESSION NUMBER: 0000899243-21-023413 CONFORMED SUBMISSION TYPE: 3/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210610 FILED AS OF DATE: 20210611 DATE AS OF CHANGE: 20210611 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Qureshi Danish J. CENTRAL INDEX KEY: 0001864331 FILING VALUES: FORM TYPE: 3/A SEC ACT: 1934 Act SEC FILE NUMBER: 001-40478 FILM NUMBER: 211012989 MAIL ADDRESS: STREET 1: 4800 N. SCOTTSDALE ROAD STREET 2: SUITE 6000 CITY: SCOTTSDALE STATE: AZ ZIP: 85251 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: LifeStance Health Group, Inc. CENTRAL INDEX KEY: 0001845257 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-HEALTH SERVICES [8000] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE BUSINESS ADDRESS: STREET 1: 4800 N. SCOTTSDALE ROAD STREET 2: SUITE 6000 CITY: SCOTTSDALE STATE: AZ ZIP: 85251 BUSINESS PHONE: 425-279-8500 MAIL ADDRESS: STREET 1: 4800 N. SCOTTSDALE ROAD STREET 2: SUITE 6000 CITY: SCOTTSDALE STATE: AZ ZIP: 85251 3/A 1 doc3a.xml FORM 3/A SUBMISSION X0206 3/A 2021-06-10 2021-06-10 0 0001845257 LifeStance Health Group, Inc. LFST 0001864331 Qureshi Danish J. C/O LIFESTANCE HEALTH GROUP, INC. 4800 N. SCOTTSDALE ROAD, SUITE 6000 SCOTTSDALE AZ 85251 0 1 0 0 Chief Growth Officer Common Stock 4318279 D Common Stock 589002 I By Trust Common Stock 589002 I By Trust Common Stock 589002 I By Trust Common Stock 589002 I By Trust Common Stock 589002 I By Trust Common Stock 589002 I By Trust Common Stock 589002 I By Trust Common Stock 589002 I By Trust Common Stock 589002 I By Trust Common Stock 589002 I By Trust Includes 3,264,998 shares of restricted stock and 550,988 restricted stock units ("RSUs"). Each RSU represents a contingent right to receive one share of the Issuer's common stock. Shares held of record by the Qureshi Marital Trust. The Reporting Person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein, and the inclusion of these securities on this report shall not be deemed an admission that the Reporting Person is the beneficial owner of the reported securities for purposes of Section 16 of the Securities Exchange Act of 1934 (the "Exchange Act") or for any other purpose. Shares held of record by the Qureshi Mother's Trust. The Reporting Person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein, and the inclusion of these securities on this report shall not be deemed an admission that the Reporting Person is the beneficial owner of the reported securities for purposes of Section 16 of the Exchange Act or for any other purpose. Shares held of record by the Qureshi Irrevocable Trust. The Reporting Person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein, and the inclusion of these securities on this report shall not be deemed an admission that the Reporting Person is the beneficial owner of the reported securities for purposes of Section 16 of the Exchange Act or for any other purpose. Shares held of record by the Qureshi Legacy Trust. The Reporting Person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein, and the inclusion of these securities on this report shall not be deemed an admission that the Reporting Person is the beneficial owner of the reported securities for purposes of Section 16 of the Exchange Act or for any other purpose. Shares held of record by the Qureshi Children's Trust. The Reporting Person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein, and the inclusion of these securities on this report shall not be deemed an admission that the Reporting Person is the beneficial owner of the reported securities for purposes of Section 16 of the Exchange Act or for any other purpose. Shares held of record by the Khan Marital Trust. The Reporting Person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein, and the inclusion of these securities on this report shall not be deemed an admission that the Reporting Person is the beneficial owner of the reported securities for purposes of Section 16 of the Exchange Act or for any other purpose. Shares held of record by the Khan Descendants Trust. The Reporting Person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein, and the inclusion of these securities on this report shall not be deemed an admission that the Reporting Person is the beneficial owner of the reported securities for purposes of Section 16 of the Exchange Act or for any other purpose. Shares held of record by the Khan Irrevocable Trust. The Reporting Person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein, and the inclusion of these securities on this report shall not be deemed an admission that the Reporting Person is the beneficial owner of the reported securities for purposes of Section 16 of the Exchange Act or for any other purpose. Shares held of record by the Khan Legacy Trust. The Reporting Person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein, and the inclusion of these securities on this report shall not be deemed an admission that the Reporting Person is the beneficial owner of the reported securities for purposes of Section 16 of the Exchange Act or for any other purpose. Shares held of record by the Khan Parents Trust. The Reporting Person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein, and the inclusion of these securities on this report shall not be deemed an admission that the Reporting Person is the beneficial owner of the reported securities for purposes of Section 16 of the Exchange Act or for any other purpose. This amendment is being filed solely to amend the original Form 3 filed by the Reporting Person to include RSUs granted in connection with the Issuer's initial public offering. By: /s/ Ryan Pardo, Attorney-in-Fact 2021-06-11