0001179110-21-010051.txt : 20211110 0001179110-21-010051.hdr.sgml : 20211110 20211110171513 ACCESSION NUMBER: 0001179110-21-010051 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211109 FILED AS OF DATE: 20211110 DATE AS OF CHANGE: 20211110 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: ORTENZIO ROCCO A CENTRAL INDEX KEY: 0000948252 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34465 FILM NUMBER: 211397806 MAIL ADDRESS: STREET 1: SELECT MEDICAL CORP STREET 2: 4716 OLD GETTYSBURG RD PO BOX 2034 CITY: MECHANICSBURG STATE: PA ZIP: 17055 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: SELECT MEDICAL HOLDINGS CORP CENTRAL INDEX KEY: 0001320414 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-HOSPITALS [8060] IRS NUMBER: 000000000 FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: C/O SELECT MEDICAL CORP STREET 2: 4714 GETTYSBURG RD CITY: MECHANICSBURG STATE: PA ZIP: 17055 BUSINESS PHONE: 717-972-1100 MAIL ADDRESS: STREET 1: C/O SELECT MEDICAL CORP STREET 2: 4714 GETTYSBURG RD CITY: MECHANICSBURG STATE: PA ZIP: 17055 4 1 edgar.xml FORM 4 - X0306 4 2021-11-09 0 0001320414 SELECT MEDICAL HOLDINGS CORP SEM 0000948252 ORTENZIO ROCCO A C/O SELECT MEDICAL HOLDINGS CORPORATION 4714 GETTYSBURG ROAD MECHANICSBURG PA 17055 1 1 0 0 Vice Chairman and Co-Founder Common Stock 2021-11-09 4 G 0 588064 0 D 901248 D Common Stock 3804805 I By the Rocco A. Ortenzio Descendants Trust Common Stock 1445195 I By the Rocco A. Ortenzio Separate Non-Exempt Descendants Trust Common Stock 3804805 I By the Rocco A. Ortenzio Separate Exempt Descendants Trust Common Stock 2136394 I By the Rocco A. Ortenzio Revocable Trust dated 8/14/07, as amended Common Stock 0 I By the Rocco A. Ortenzio October 2019 GRAT Common Stock 1630230 I By the Rocco A. Ortenzio July 2020 GRAT Common Stock 30601 I By Select Investments III, L.P. Common Stock 16182 I By Select AP Investors, L.P. Common Stock 10000 I By spouse Common Stock 274945 I By the Rocco A. Ortenzio 2014 Trust for Robert A. Ortenzio Common Stock 218275 I The Rocco A. Ortenzio 2014 Trust FBO John M. Ortenzio Common Stock 218275 I The Rocco A. Ortenzio 2014 Trust FBO Martin J. Ortenzio 588,064 shares were previously owned by, and were contributed by, The Rocco A Ortenzio October 2019 GRAT to Rocco A. Ortenzio. Rocco A. Ortenzio then contributed the shares to the Rocco A. Ortenzio Revocable Trust DRD 8/14/2007. The reporting person beneficially owns the reported securities indirectly, but disclaims beneficial ownership of the reported securities except to the extent of his pecuniary interest therein. The shares were previously owned by, and were contributed by, The Rocco A Ortenzio October 2019 GRAT to The Rocco A. Ortenzio 2014 Trust FBO John M. Ortenzio. The shares were previously owned by, and were contributed by, The Rocco A Ortenzio October 2019 GRAT to The Rocco A. Ortenzio 2014 Trust FBO Martin J. Ortenzio. 218,276 shares were previously owned by, and were contributed by, The Rocco A Ortenzio October 2019 GRAT to The Rocco A. Ortenzio 2014 Trust FBO Robert A. Ortenzio. /s/ Michael E. Tarvin, as attorney-in-fact 2021-11-10