1. Name and Address of Reporting Person*BAIN CAPITAL INVESTORS LLC |
C/O BAIN CAPITAL PRIVATE EQUITY, LP |
200 CLARENDON STREET |
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 06/06/2024
|
3. Issuer Name and Ticker or Trading Symbol
Waystar Holding Corp.
[ WAY ]
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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 |
|
1. Name and Address of Reporting Person*BAIN CAPITAL INVESTORS LLC |
C/O BAIN CAPITAL PRIVATE EQUITY, LP |
200 CLARENDON STREET |
(Street)
|
1. Name and Address of Reporting Person*
(Street)
|
1. Name and Address of Reporting Person*
(Street)
|
1. Name and Address of Reporting Person*Bain Capital Fund XI, L.P. |
(Street)
|
1. Name and Address of Reporting Person*Bain Capital Partners XI, L.P. |
(Street)
|
|
Bain Capital Investors, LLC, By: /s/ David Humphrey, Title: Authorized Signatory |
06/07/2024 |
|
BCPE Derby Investor, LP, By: BCPE Derby GP, LLC, its general partner, By: Bain Capital Fund XI, L.P. its member, By: Bain Capital Partners XI, L.P. its general partner, By: Bain Capital Investors, LLC its general partner, By: /s/ David Humphrey, Title: A |
06/07/2024 |
|
BCPE Derby GP, LLC, By: Bain Capital Fund XI, L.P. its member, By: Bain Capital Partners XI, L.P. its general partner, By: Bain Capital Investors, LLC its general partner, By: /s/ David Humphrey, Title: Authorized Signatory |
06/07/2024 |
|
Bain Capital Fund XI, LP, By: Bain Capital Partners XI, LP, its general partner, By: Bain Capital Investors, LLC, its manager, By: /s/ David Humphrey, Title: Authorized Signatory |
06/07/2024 |
|
Bain Capital Partners XI, LP, By: Bain Capital Investors, LLC, its manager, By: /s/ David Humphrey, Title: Authorized Signatory |
06/07/2024 |
|
** 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). |
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. |