SEC FORM 3 SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF 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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1. Name and Address of Reporting Person*
Avista Capital Partners III GP, L.P.

(Last) (First) (Middle)
C/O AVISTA CAPITAL PARTNERS
65 EAST 55TH STREET, 18TH FLOOR

(Street)
NEW YORK NY 10022

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
10/18/2018
3. Issuer Name and Ticker or Trading Symbol
Osmotica Pharmaceuticals plc [ OSMT ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director X 10% Owner
Officer (give title below) Other (specify below)
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
Form filed by One Reporting Person
X Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Ordinary Shares 8,654,948 I By investment fund(1)
Ordinary Shares 4,825,916 I By investment fund(2)
Ordinary Shares 4,936,926 I By investment fund(3)
Ordinary Shares 1,032,995 I By investment fund(4)
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
1. Name and Address of Reporting Person*
Avista Capital Partners III GP, L.P.

(Last) (First) (Middle)
C/O AVISTA CAPITAL PARTNERS
65 EAST 55TH STREET, 18TH FLOOR

(Street)
NEW YORK NY 10022

(City) (State) (Zip)
1. Name and Address of Reporting Person*
ACP III AIV, L.P.

(Last) (First) (Middle)
C/O AVISTA CAPITAL PARTNERS
65 EAST 55TH STREET, 18TH FLOOR

(Street)
NEW YORK NY 10022

(City) (State) (Zip)
1. Name and Address of Reporting Person*
ACP Holdco (Offshore), L.P.

(Last) (First) (Middle)
C/O AVISTA CAPITAL PARTNERS
65 EAST 55TH STREET, 18TH FLOOR

(Street)
NEW YORK NY 10022

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Orbit Co-Invest I LLC

(Last) (First) (Middle)
C/O AVISTA CAPITAL PARTNERS
65 EAST 55TH STREET, 18TH FLOOR

(Street)
NEW YORK NY 10022

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Orbit Co-Invest III LLC

(Last) (First) (Middle)
C/O AVISTA CAPITAL PARTNERS
65 EAST 55TH STREET, 18TH FLOOR

(Street)
NEW YORK NY 10022

(City) (State) (Zip)
Explanation of Responses:
1. Represents shares of the Issuer held by ACP III AIV, L.P. Avista Capital Partners III GP, L.P. ("ACP GP") is the general partner of ACP III AIV, L.P. As a result, ACP GP may be deemed to share voting and investment power with respect to the shares held by ACP III AIV, L.P. Each of ACP III AIV, L.P. and ACP GP disclaims beneficial ownership of such shares, except to the extent of its pecuniary interest therein, and the inclusion of the shares in this report shall not be deemed to be an admission of beneficial ownership of the reported shares for purposes of Section 16 of the Securities Exchange Act of 1934 or otherwise.
2. Represents shares of the Issuer held by ACP Holdco (Offshore), L.P. ACP GP is the general partner of ACP Holdco (Offshore), L.P. As a result, ACP GP may be deemed to share voting and investment power with respect to the shares held by ACP Holdco (Offshore), L.P. Each of ACP Holdco (Offshore), L.P. and ACP GP disclaims beneficial ownership of such shares, except to the extent of its pecuniary interest therein, and the inclusion of the shares in this report shall not be deemed to be an admission of beneficial ownership of the reported shares for purposes of Section 16 of the Securities Exchange Act of 1934 or otherwise.
3. Represents shares of the Issuer held by Orbit Co-Invest I LLC. ACP GP is the manager of Orbit Co-Invest I LLC. As a result, ACP GP may be deemed to share voting and investment power with respect to the shares held by Orbit Co-Invest I LLC. Each of Orbit Co-Invest I LLC. and ACP GP disclaims beneficial ownership of such shares, except to the extent of its pecuniary interest therein, and the inclusion of the shares in this report shall not be deemed to be an admission of beneficial ownership of the reported shares for purposes of Section 16 of the Securities Exchange Act of 1934 or otherwise.
4. Represents shares of the Issuer held by Orbit Co-Invest III LLC. ACP GP is the manager of Orbit Co-Invest III LLC. As a result, ACP GP may be deemed to share voting and investment power with respect to the shares held by Orbit Co-Invest III LLC.. Each of Orbit Co-Invest III LLC and ACP GP disclaims beneficial ownership of such shares, except to the extent of its pecuniary interest therein, and the inclusion of the shares in this report shall not be deemed to be an admission of beneficial ownership of the reported shares for purposes of Section 16 of the Securities Exchange Act of 1934 or otherwise.
Avista Capital Partners III GP, L.P. By: /s/ Ben Silbert, Chief Administrative Officer and General Counsel 10/18/2018
ACP III AIV, L.P., by Avista Capital Partners III GP, L.P., its general partner By: /s/ Ben Silbert, Chief Administrative Officer and General Counsel 10/18/2018
ACP Holdco (Offshore), L.P., by Avista Capital Partners III GP, L.P., its general partner By: /s/ Ben Silbert, Chief Administrative Officer and General Counsel 10/18/2018
Orbit Co-Invest I LLC, by Avista Capital Partners III GP, L.P., its general partner By: /s/ Ben Silbert, Chief Administrative Officer and General Counsel 10/18/2018
Orbit Co-Invest III LLC, by Avista Capital Partners III GP, L.P., its general partner By: /s/ Ben Silbert, Chief Administrative Officer and General Counsel 10/18/2018
** 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 5 (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).
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