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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES 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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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
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 control number. | SEC 1474 (9-02) |
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 Underlying Securities (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 of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Series A Preferred Stock | (1) | 10/12/2021 | C | 244,856 (2) | (1) | (1) | Common Stock | 301,571 | (1) | 0 | I | See footnote (3) |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Partners Group Private Equity (Master Fund), LLC C/O PARTNERS GROUP (USA) INC. 1200 ENTREPRENURIAL DRIVE BROOMFIELD, CO 80021 |
X | |||
Partners Group Private Equity II, LLC C/O PARTNERS GROUP (USA) INC. 1200 ENTREPRENURIAL DRIVE BROOMFIELD, CO 80021 |
X |
By: /s/ Justin Rindos, Chief Financial Officer, Partners Group Private Equity (Master Fund), LLC | 10/13/2021 | |
**Signature of Reporting Person | Date | |
By: /s/ Justin Rindos, Authorized Signatory of the advisor to Partners Group Private Equity II, LLC | 10/13/2021 | |
**Signature of Reporting Person | Date |
* | 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). |
(1) | Each share of Life Time Group Holdings, Inc.'s (the "Issuer") Series A Preferred Stock (the "Series A Preferred Stock") automatically converted into shares of the Issuer's common stock (the "Common Stock") upon the closing of the Issuer's initial public offering, for no additional consideration, in accordance with the Certificate of Designations of the Series A Preferred Stock. The Series A Preferred Stock had no expiration date. |
(2) | Partners Group Private Equity (Master Fund), LLC ("PG Master Fund") directly held 140,583 shares of Series A Preferred Stock, Partners Group Private Equity II, LLC ("PG PE II") directly held 3,218 shares of Series A Preferred Stock and Partners Group Access 83 PF LP ("PG Access 83") directly held 101,055 shares of Series A Preferred Stock. |
(3) | PG Master Fund, PG PE II, PG Access 83 and Partners Group Series Access II, LLC, Series 61 ("PG Series 61") are indirectly controlled by Partners Group Holding AG ("Partners Group"). Each of PG Master Fund, PG PE II, PG Access 83 and PG Series 61 disclaims beneficial ownership of any securities that it does not directly beneficially own, except to the extent of its pecuniary interest, if any, therein. |
(4) | 3,305,146 of such shares of Common Stock are directly held by PG Master Fund, 3,963 of such shares are directly held by PG PE II, 124,462 of such shares are directly held by PG Access 83 and 2,868,000 of such shares are directly held by PG Series 61. |
(5) | 3,464,630 of such shares of Common Stock are directly held by PG Master Fund, 7,614 of such shares are directly held by PG PE II, 239,104 of such shares are directly held by PG Access 83 and 2,868,000 of such shares are directly held by PG Series 61. |