UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES 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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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | SEC 1473 (7-02) | ||
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 control number. |
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 of Derivative Security: Direct (D) or Indirect (I) (Instr. 5) |
6. Nature of Indirect Beneficial Ownership (Instr. 5) |
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Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Gen4 Trust Advisor LLC 950 TOWER LANE, SUITE 800 FOSTER CITY, CA 94404 |
 |  |  | See footnote (1) |
/s/ Gen4 Trust Advisor LLC, by Robert B. Hellman Jr., Member | 12/02/2010 | |
**Signature of Reporting Person | Date |
No securities are beneficially owned | |
* | 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). |
 Remarks: No securities beneficially owned. The Reporting Person is a trust advisor to three newly formed liquidating trusts that may be deemed to be a Section 13(d) group that beneficially owns greater than 10% of the outstanding common units representing limited partnership interests of the Issuer. The Reporting Person serves as the trust advisor for MDC IV Trust U/T/A November 30, 2010 ("MDC IV Trust"), MDC IV Associates Trust U/T/A November 30, 2010 ("MDC IVA Trust"), and Delta Fund Trust U/T/A November 30, 2010 ("Delta Trust" and, collectively with MDC IV Trust and MDC IVA Trust, the "Trusts"). The Trusts collectively control CFSI LLC, a Delaware limited liability company ("CFSI") which directly holds securities of the Issuer. The Trusts also collectively control Cornerstone Family Services LLC, a Delaware limited liability company ("Cornerstone"), which has an equity interest in CFSI. Voting and investment decisions for each of the Trusts are directed by the Reporting Person, of which Mr. Robert B. Hellman Jr. serves as the sole member and, in such capacity, has investment and voting control over the shares held by the Trusts. However, the Reporting Person has no economic interest in the securities held by the Trusts. |