Sec Form 3 Filing - STAFFIERI MICHAEL DAVID @ DAVITA INC. - 2019-10-04

Insider filing report for Changes in Beneficial Ownership
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FORM 3
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
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, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
STAFFIERI MICHAEL DAVID
2. Issuer Name and Ticker or Trading Symbol
DAVITA INC. [ DVA]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director _____ 10% Owner
X __ Officer (give title below) _____ Other (specify below)
Chief Operating Officer, DKC
(Last) (First) (Middle)
C/O DAVITA INC., 2000 16TH STREET
3. Date of Earliest Transaction (MM/DD/YY)
10/04/2019
(Street)
DENVER, CO80202
4. If Amendment, Date Original Filed (MM/DD/YY)
6. Individual or Joint/Group Filing (Check Applicable Line)
__ X __ Form filed by One Reporting Person
_____ Form filed by More than One Reporting Person
(City) (State) (Zip)
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1.Title of Security
(Instr. 3)
2. Transaction Date (MM/DD/YY) 2A. Deemed Execution Date, if any (MM/DD/YY) 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 86,945 ( 1 ) D
Common Stock 47,315 I by 2012 Staffieri Family Trust
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 (MM/DD/YY) 3A. Deemed Execution Date, if any (MM/DD/YY) 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
(MM/DD/YY)
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)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Stock Appreciation Rights $ 83.82 ( 2 ) 06/02/2020 Common Stock 40,284 D
Stock Appreciation Rights $ 75.42 ( 3 ) 05/13/2021 Common Stock 66,477 D
Stock Appreciation Rights $ 65.48 ( 4 ) 06/06/2022 Common Stock 74,201 D
Stock Appreciation Rights $ 66.29 ( 5 ) 05/15/2023 Common Stock 243,994 D
Common Stock $ 52.41 ( 6 ) 06/20/2024 Common Stock 200,000 D
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
STAFFIERI MICHAEL DAVID
C/O DAVITA INC.
2000 16TH STREET
DENVER, CO80202
Chief Operating Officer, DKC
Signatures
/s/ Stephanie N. Berberich, Attorney-in-Fact 10/15/2019
Signature of Reporting Person Date
Explanation of Responses:
( 1 )Includes (i) 79,650 restricted stock units granted on May 15, 2019, which are scheduled to vest 50% each on May 15, 2022 and May 15, 2023, respectively, and (ii) 4,093 restricted stock units granted on December 24, 2016, which are scheduled to vest in full on May 15, 2020. Each of the foregoing vestings is subject to continued service through each applicable vesting date.
( 2 )The Stock Appreciation Rights were granted on June 2, 2015, and are fully vested as of the date hereof.
( 3 )The Stock Appreciation Rights were granted on May 13, 2016, with 50% having vested on May 13, 2019 and the remaining 50% scheduled to vest on May 13, 2020, subject to continued service through the applicable vesting date.
( 4 )The Stock Appreciation Rights were granted on June 6, 2017, and are scheduled to vest 50% each on May 15, 2020 and May 15, 2021, respectively, subject to continued service through the applicable vesting date.
( 5 )The Stock Appreciation Rights were granted on May 15, 2018, and are scheduled to vest 50% each on May 15, 2021 and May 15, 2022, respectively, subject to continued service through the applicable vesting date.
( 6 )The Stock Appreciation Rights were granted on June 20, 2019, and are scheduled to vest 50% each on June 20, 2021 and June 20, 2023, respectively, subject to continued service through the applicable vesting date.

Remarks:
Exhibit ListExhibit 24 - Power of Attorney

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