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- -------- UNITED STATES SECURITIES AND EXCHANGE COMMISSION -----------------------------
FORM 4 WASHINGTON, D.C. 20549 OMB APPROVAL
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/X/ CHECK THIS BOX IF NO STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OMB NUMBER: 3235-0287
LONGER SUBJECT TO EXPIRES: DECEMBER 31, 2001
SECTION 16. FORM 4 OR Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, ESTIMATED AVERAGE BURDEN
FORM 5 OBLIGATIONS MAY Section 17(a) of the Public Utility Holding Company Act of 1935 or HOURS PER RESPONSE .... 0.5
CONTINUE. SEE Section 30(f) of the Investment Company Act of 1940 -----------------------------
INSTRUCTION 1(b).
(Print or Type Responses)
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1. Name and Address of Reporting Person* 2. Issuer Name and Ticker or Trading Symbol 6. Relationship of Reporting Person(s)
to Issuer (Check all applicable)
Appollo Investment Fund III, L.P. Mariner Post-Acute Network, Inc. ("MPAN") Director X 10% Owner
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(Last) (First) (Middle) 3. IRS or Social Security 4. Statement for ---- title ---- (specify
Number of Reporting Month/Year below) below
Two Manhattanville Road Person (Voluntary) ----------------- ------------------
December 1999
- -------------------------------------------- --------------------- 7. Individual or Joint/Group Filing
(Street) 5. If Amendment, (Check Applicable Line)
Date of Original Form filed by One Reporting Person
(Month/Year) ---
X Form filed by More than One
Purchase, NY 10577 ---Reporting Person
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(City) (State) (Zip) TABLE I - NON-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED
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1. Title of Security 2. Trans- 3. Trans- 4. Securities Acquired (A) 5. Amount of 6. Owner- 7. Nature
(Instr. 3) action action or Disposed of (D) Securities ship of In-
Date Code (Instr. 3, 4 and 5) Beneficially Form: direct
(Instr. 8) Owned at Direct Bene-
(Month/ End of (D) or ficial
Day/ ------------------------------------------- Month Indirect Owner-
Year) (A) or (I) ship
Code V Amount (D) Price (Instr. 3 (Instr. 4) (Instr. 4)
and 4)
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Common Stock, par value 12/20/99 S 13,774,998 D # D
$0.01 per share ##
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Common Stock, par value 12/24/99 S 592,293 D ### 2,821 D
$0.01 per share
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (Page 1 of 4)
* If the form is filed by more than one reporting person, SEE Instruction 4(b)(v). SEC 1474 (3-99)
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1. Name and Address of Reporting Person 2. Issuer Name and Ticker or Trading Symbol 4. Statement for Month/Year
Appollo Investment Fund III, L.P. Mariner Post-Acute Network, Inc. ("MPAN") December 1999
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FORM 4 (CONTINUED) TABLE II - DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED
(E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES)
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1. Title of Derivative Security 2. Conver- 3. Trans- 4. Transac- 5. Number of Deriv- 6. Date Exer-
(Instr. 3) sion or action tion Code ative Securities Ac- cisable and Ex-
Exercise Date (Instr. 8) quired (A) or Dis- piration Date
Price of (Month/ posed of (D) (Month/Day/
Deriv- Day/ (Instr. 3, 4, and 5) Year)
ative Year)
Security
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Date Expira-
-------------------------------------- Exer- tion
cisable Date
Code V (A) (D)
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7. Title and Amount of Under- 8. Price 9. Number 10. Owner- 11. Nature
lying Securities of of Deriv- ship of In-
(Instr. 3 and 4) Deriv- ative Form direct
ative Securi- of De- Bene-
Secur- ties rivative ficial
ity Bene- Secu- Own-
(Instr. ficially rity: ership
5) Owned Direct (Instr. 4)
at End (D) or
Amount or of Indi-
Title Number of Month rect (I)
Shares (Instr. 4) (Instr. 4)
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Explanation of Responses:
# The consideration consisted of an aggregate of (i) $2,000,000 in cash, (ii)
preferred equity securities of the purchaser and (iii) a "put option" to the
purchaser of the preferred equity securities; such consideration was paid to
the Funds (as defined in the footnote below).
## The shares reported on this Form 4 are owned by Apollo Investment Fund
III, L.P. ("Fund III"), Apollo Overseas Partners III, L.P. ("Overseas
Partners") and Apollo UK Partners III, L.P. ("UK Partners,"" and together
with Fund III and Overseas Partners, the "Funds"). The general partner of
each of the Funds is Apollo Advisors II, L.P. ("Advisors"), whose general
partner is Apollo Capital Management II, Inc. ("Apollo Capital"); the
day-to-day manager of each of the Funds is Apollo Management, L.P., whose
general partner is AIF III Management, Inc. ("AIF Management"). Messrs. Leon
Black and John Hannan, executive officers and directors of Apollo Capital and
AIF Management, and principals of Advisors and Apollo Management, disclaim
beneficial ownership of the shares beneficially owned by any of the Funds. As
permitted by the SEC rules, the number of shares reported on this Form 4
exceeds the proportionate pecuniary interest of the Reporting Person in the
equity securities of the Issuer.
### The consideration received consisted of 2,821 shares of the Issuer's
common stock; these shares were received from Chase Equity Associates, L.P.
("Chase") in connection with Chase's cashless exercise of a warrant to
purchase 592,593 shares of the Issuer's common stock.
Note: File three copies of this Form, one of which must be manually signed.
If space is insufficient, SEE Instruction 6 for procedure.
Potential persons who are to respond to the collection of information contained
in this form are not required to respond unless the form displays a currently
valid OMB Number.
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(Page 2 of 4)
SEC 1474 (3-99)
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1. Name and Address of Reporting Person 2. Issuer Name and Ticker or Trading Symbol 4. Statement for Month/Year
Appollo Investment Fund III, L.P. Mariner Post-Acute Network, Inc. ("MPAN") December 1999
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1. APOLLO INVESTMENT FUND III, L.P. APOLLO INVESTMENT FUND III, L.P. January 7, 2000
Two Manhattanville Road ---------------
Purchase, NY 10577 By: Apollo Advisors II, L.P., Date
Its General Partner
By: Apollo Capital Management II, Inc.,
Its General Partner
By: /s/ Michael D. Weiner
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Name: Michael D. Weiner
Title: Vice President
2. APOLLO OVERSEAS PARTNERS III, L.P. APOLLO OVERSEAS PARTNERS III, L.P. January 7, 2000
Two Manhattanville Road ---------------
Purchase, NY 10577 By: Apollo Advisors II, L.P., Date
Its General Partner
By: Apollo Capital Management II, Inc.,
Its General Partner
By: /s/ Michael D. Weiner
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Name: Michael D. Weiner
Title: Vice President
3. APOLLO UK PARTNERS III, L.P. APOLLO UK PARTNERS III, L.P. January 7, 2000
Two Manhattanville Road ---------------
Purchase, NY 10577 By: Apollo Advisors II, L.P., Date
Its General Partner
By: Apollo Capital Management II, Inc.,
Its General Partner
By: /s/ Michael D. Weiner
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Name: Michael D. Weiner
Title: Vice President
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (Page 3 of 4)
* If the form is filed by more than one reporting person, SEE Instruction 4(b)(v). SEC 1474 (3-99)
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1. Name and Address of Reporting Person 2. Issuer Name and Ticker or Trading Symbol 4. Statement for Month/Year
Appollo Investment Fund III, L.P. Mariner Post-Acute Network, Inc. ("MPAN") December 1999
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4. APOLLO ADVISORS II, L.P. APOLLO ADVISORS II, L.P. January 7, 2000
Two Manhattanville Road ---------------
Purchase, NY 10577 By: Apollo Capital Management II, Inc., Date
Its General Partner
By: /s/ Michael D. Weiner
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Name: Michael D. Weiner
Title: Vice President
5. APOLLO MANAGEMENT, L.P. APOLLO MANAGEMENT, L.P. January 7, 2000
Two Manhattanville Road ---------------
Purchase, NY 10577 By: AIF III Management, Inc., Date
Its General Partner
By: /s/ Michael D. Weiner
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Name: Michael D. Weiner
Title: Vice President
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Note: File three copies of this Form, one of which must be manually signed. If space provided is insufficient,
SEE Instruction 6 for procedure. Potential persons who are to respond to the collection of information contained (Page 4 of 4)
in this form are not required to respond unless the form displays a currently valid QMB Number. SEC 1474 (3-99)
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