Sec Form 3 Filing - Hellman & Friedman LLC @ Change Healthcare Inc. - 2019-06-27

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
Hellman & Friedman LLC
2. Issuer Name and Ticker or Trading Symbol
Change Healthcare Inc. [ CHNG]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director X __ 10% Owner
_____ Officer (give title below) _____ Other (specify below)
(Last) (First) (Middle)
415 MISSION STREET, SUITE 5700,
3. Date of Earliest Transaction (MM/DD/YY)
06/27/2019
(Street)
SAN FRANCISCO, CA94105
4. If Amendment, Date Original Filed (MM/DD/YY)
6. Individual or Joint/Group Filing (Check Applicable Line)
_____ Form filed by One Reporting Person
__ X __ 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 5,145,941 I See Footnote ( 1 ) ( 6 )
Common Stock 9,880,986 I See Footnote ( 2 ) ( 6 )
Common Stock 44,183 I See Footnote ( 3 ) ( 6 )
Common Stock 4,993 I See Footnote ( 4 ) ( 6 )
Common Stock 55,341 I See Footnote ( 5 ) ( 6 )
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
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Hellman & Friedman LLC
415 MISSION STREET, SUITE 5700
SAN FRANCISCO, CA94105
X
Hellman & Friedman Investors VI, L.P.
C/O HELLMAN & FRIEDMAN LLC
415 MISSION STREET, SUITE 5700
SAN FRANCISCO, CA94105
X
H&F Harrington AIV II, L.P.
C/O HELLMAN & FRIEDMAN LLC
415 MISSION STREET, SUITE 5700
SAN FRANCISCO, CA94105
X
HFCP VI Domestic AIV, L.P.
C/O HELLMAN & FRIEDMAN LLC
415 MISSION STREET, SUITE 5700
SAN FRANCISCO, CA94105
X
Hellman & Friedman Capital Executives VI LP
C/O HELLMAN & FRIEDMAN LLC
415 MISSION STREET, SUITE 5700
SAN FRANCISCO, CA94105
X
Hellman & Friedman Capital Associates VI, L.P.
C/O HELLMAN & FRIEDMAN LLC
415 MISSION STREET, SUITE 5700
SAN FRANCISCO, CA94105
X
Signatures
HELLMAN & FRIEDMAN LLC, By: /s/ Trevor Watt, Name: Trevor Watt, Title: Partner 06/27/2019
Signature of Reporting Person Date
HELLMAN & FRIEDMAN INVESTORS VI, L.P., By: Hellman & Friedman LLC, as general partner, By: /s/ Trevor Watt, Name: Trevor Watt, Title: Partner 06/27/2019
Signature of Reporting Person Date
H&F HARRINGTON AIV II, L.P., By: Hellman & Friedman Investors VI, L.P., as general partner, By: Hellman & Friedman LLC, as general partner, By: /s/ Trevor Watt, Name: Trevor Watt, Title: Partner 06/27/2019
Signature of Reporting Person Date
HFCP VI DOMESTIC AIV, L.P., By: Hellman & Friedman Investors VI, L.P., as general partner, By: Hellman & Friedman LLC, as general partner, By: /s/ Trevor Watt, Name: Trevor Watt, Title: Partner 06/27/2019
Signature of Reporting Person Date
HELLMAN & FRIEDMAN CAPITAL EXECUTIVES VI, L.P., By: Hellman & Friedman Investors VI, L.P., as general partner, By: Hellman & Friedman LLC, as general partner, By: /s/ Trevor Watt, Name: Trevor Watt, Title: Partner 06/27/2019
Signature of Reporting Person Date
HELLMAN & FRIEDMAN CAPITAL ASSOCIATES VI, L.P., By: Hellman & Friedman Investors VI, L.P., as general partner, By: Hellman & Friedman LLC, as general partner, By: /s/ Trevor Watt, Name: Trevor Watt, Title: Partner 06/27/2019
Signature of Reporting Person Date
Explanation of Responses:
( 1 )Reflects securities directly held by H&F Harrington AIV II, L.P.
( 2 )Reflects securities directly held by HFCP VI Domestic AIV, L.P.
( 3 )Reflects securities directly held by Hellman & Friedman Capital Executives VI, L.P.
( 4 )Reflects securities directly held by Hellman & Friedman Capital Associates VI, L.P.
( 5 )Reflects securities directly held by Hellman & Friedman Investors VI, L.P. (collectively with H&F Harrington AIV II, L.P., HFCP VI Domestic AIV, L.P., Hellman & Friedman Capital Executives VI, L.P. and Hellman & Friedman Capital Associates VI, L.P., the "H&F Entities").
( 6 )The general partner of each of H&F Harrington AIV II, L.P., HFCP VI Domestic AIV, L.P., Hellman & Friedman Capital Executives VI, L.P. and Hellman & Friedman Capital Associates VI, L.P. is Hellman & Friedman Investors VI, L.P. The general partner of Hellman & Friedman Investors VI, L.P. is Hellman & Friedman LLC. A four member investment committee of Hellman & Friedman LLC has investment discretion over the shares held by the H&F Entities. Each of the members of the investment committee disclaims beneficial ownership of such shares, except to the extent of any respective pecuniary interest therein.

Remarks:
Pursuant to Rule 16a-1(a)(4) of the Securities Exchange Act of 1934, as amended, each Reporting Person states that this filing shall not be an admission that such Reporting Person is the beneficial owner of any of the securities reported herein, and such Reporting Person disclaims beneficial ownership of such securities except to the extent of such Reporting Person's pecuniary interest therein.

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