SEC FORM 4 SEC Form 4
FORM 4 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
or Section 30(h) of the Investment Company Act of 1940
 
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
Speers Andrea Carolan

(Last) (First) (Middle)
228 STRAWBRIDGE DRIVE

(Street)
MOORESTOWN NJ 08057

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
Tabula Rasa HealthCare, Inc. [ TRHC ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Chief Accounting Officer
3. Date of Earliest Transaction (Month/Day/Year)
03/11/2021
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 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 03/11/2021 M 26,612 A $44.14 67,704 D
Common Stock 03/11/2021 D 6,218 D $44.14 61,486 D
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 (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 Securities Underlying Derivative Security (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: 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
Employee Stock Option (right to buy) $1.56 03/11/2021 M 1,288 (1) 02/01/2022 Common Stock 1,288 $0.00 0 D
Employee Stock Option (right to buy) $2.14 03/11/2021 M 4,217 (2) 02/20/2022 Common Stock 4,217 $0.00 0 D
Employee Stock Option (right to buy) $3.11 03/11/2021 M 773 (3) 01/02/2023 Common Stock 773 $0.00 0 D
Employee Stock Option (right to buy) $5.82 03/11/2021 M 1,546 (4) 01/01/2024 Common Stock 1,546 $0.00 0 D
Employee Stock Option (right to buy) $5.82 03/11/2021 M 1,288 (5) 01/02/2023 Common Stock 1,288 $0.00 0 D
Employee Stock Option (right to buy) $14.23 03/11/2021 M 7,500 (6) 10/21/2026 Common Stock 7,500 $0.00 0 D
Employee Stock Option (right to buy) $13.78 03/11/2021 M 10,000 (7) 03/10/2027 Common Stock 10,000 $0.00 0 D
Explanation of Responses:
1. The Stock Option vested 25% on February 1, 2013 and vested in equal 1/36th installments each month thereafter.
2. The Stock Option vested on December 20, 2012.
3. The Stock Option vested 25% on January 2, 2014 and vested in equal 1/36th installments each month thereafter.
4. The Stock Option vested 25% on January 1, 2015 and vested in equal 1/36th installments thereafter.
5. The Stock Option vested 25% on January 1, 2016 and vested in equal 1/36th installments each month thereafter.
6. The Stock Option vested one-third on October 21, 2017 and has continued to vest in equal 1/24th installments each month thereafter.
7. The Stock Option vested 25% on March 10, 2018 and vested in equal 1/36th installments each month thereafter.
/s/ Brian W. Adams, by Power of Attorney 03/12/2021
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* 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).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
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 Number.