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* Welsh, Carson, Anderson & Stowe XII, L.P. (Last) (First) (Middle) C/O WELSH, CARSON, ANDERSON AND STOWE, 599 LEXINGTON AVENUE, SUITE 1800 (Street) NEW YORK NY 10022 (City) (State) (Zip)	2. Date of Event Requiring Statement (Month/Day/Year) 03/03/2021	3. Issuer Name and Ticker or Trading Symbol InnovAge Holding Corp. [ INNV ]
		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)
Common stock, $0.001 par value	116,520,612	I	See Footnote(1)(2)(3)

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* Welsh, Carson, Anderson & Stowe XII, L.P. (Last) (First) (Middle) C/O WELSH, CARSON, ANDERSON AND STOWE, 599 LEXINGTON AVENUE, SUITE 1800 (Street) NEW YORK NY 10022 (City) (State) (Zip)

1. Name and Address of Reporting Person* WCAS CO-INVEST ASSOCIATES LLC (Last) (First) (Middle) C/O WELSH, CARSON, ANDERSON AND STOWE 599 LEXINGTON AVENUE, SUITE 1800 (Street) NEW YORK NY 10022 (City) (State) (Zip)

1. Name and Address of Reporting Person* Welsh, Carson, Anderson & Stowe XII Delaware, L.P. (Last) (First) (Middle) C/O WELSH, CARSON, ANDERSON AND STOWE 599 LEXINGTON AVENUE, SUITE 1800 (Street) NEW YORK NY 10022 (City) (State) (Zip)

1. Name and Address of Reporting Person* Welsh, Carson, Anderson & Stowe XII Delaware II, L.P. (Last) (First) (Middle) C/O WELSH, CARSON, ANDERSON AND STOWE 599 LEXINGTON AVENUE, SUITE 1800 (Street) NEW YORK NY 10022 (City) (State) (Zip)

1. Name and Address of Reporting Person* Welsh, Carson, Anderson & Stowe XII Cayman, L.P. (Last) (First) (Middle) C/O WELSH, CARSON, ANDERSON AND STOWE 599 LEXINGTON AVENUE, SUITE 1800 (Street) NEW YORK NY 10022 (City) (State) (Zip)

1. Name and Address of Reporting Person* WCAS XII Co-Investors LLC (Last) (First) (Middle) C/O WELSH, CARSON, ANDERSON AND STOWE 599 LEXINGTON AVENUE, SUITE 1800 (Street) NEW YORK NY 10022 (City) (State) (Zip)

1. Name and Address of Reporting Person* WCAS MANAGEMENT CORP (Last) (First) (Middle) C/O WELSH, CARSON, ANDERSON AND STOWE 599 LEXINGTON AVENUE, SUITE 1800 (Street) NEW YORK NY 10022 (City) (State) (Zip)

1. Name and Address of Reporting Person* WCAS - CO-INVEST HOLDCO, L.P. (Last) (First) (Middle) C/O WELSH, CARSON, ANDERSON AND STOWE 599 LEXINGTON AVENUE, SUITE 1800 (Street) NEW YORK NY 10022 (City) (State) (Zip)

1. Name and Address of Reporting Person* WCAS XII ASSOCIATES LLC (Last) (First) (Middle) C/O WELSH, CARSON, ANDERSON AND STOWE 599 LEXINGTON AVENUE, SUITE 1800 (Street) NEW YORK NY 10022 (City) (State) (Zip)

1. Name and Address of Reporting Person* WCAS XII ASSOCIATES CAYMAN, L.P. (Last) (First) (Middle) C/O WELSH, CARSON, ANDERSON AND STOWE 599 LEXINGTON AVENUE, SUITE 1800 (Street) NEW YORK NY 10022 (City) (State) (Zip)

Explanation of Responses:

1. The limited partners of TCO Group Holdings, L.P. may control the voting and dispositive power with respect to the common stock if Welsh, Carson, Anderson & Stowe XII, L.P. ("WCAS XII"), Welsh, Carson, Anderson & Stowe XII Delaware, L.P. ("WCAS XII-D"), Welsh, Carson, Anderson & Stowe XII Delaware II, L.P. ("WCAS XII-DII"), Welsh, Carson, Anderson & Stowe XII Cayman, L.P. ("WCAS XII-C"), WCAS XII Co-Investors LLC ("WCAS XII-Co"), WCAS Management Corporation and WCAS Co-Invest Holdco, L.P. (collectively, the "WCAS Investor") consents to a change to the delegation of authority to the committee of limited partners that controls TCO Group Holdings, L.P.

2. The general partner of each of WCAS XII and WCAS XII-DII is WCAS XII Associates LLC ("WCAS XII Associates"). The general partner of each of WCAS XII-D and WCAS XII-C is WCAS XII Associates Cayman, L.P. The general partner of WCAS XII Associates Cayman, L.P. is WCAS XII Associates.

3. The managing members of WCAS XII Associates is Thomas A. Scully, Sean Traynor, Anthony deNicola, D. Scott Mackesy, Brian Regan, Michael Donovan, Eric Lee, Christopher Hooper, Christopher Solomon, Edward Sobol, Gregory Lau, Frances Higgins, Nicholas O'Leary, Jonathan Rather and Ryan Harper (collectively, the "WCAS GP"). The general partner of WCAS Co-Invest Holdco, L.P. is WCAS Co-Invest Associates LLC. The managing members of each of WCAS XII-Co and WCAS Co-Invest Associates, LLC is the WCAS GP. Anthony deNicola, D. Scott Mackesy, Jonathan Rather, Brian Regan, Michael Donovan and Eric Lee ("WCAS Board") comprise the board of directors of WCAS Management Corporation.

	Welsh, Carson, Anderson & Stowe XII, L.P., By: /s/ Thomas Scully, Authorized Signatory	03/03/2021
	Welsh, Carson, Anderson & Stowe XII Delaware, L.P., By: /s/ Thomas Scully, Authorized Signatory	03/03/2021
	Welsh, Carson, Anderson & Stowe XII Delaware II, L.P., By: /s/ Thomas Scully, Authorized Signatory	03/03/2021
	Welsh, Carson, Anderson & Stowe XII Cayman, L.P., By: /s/ Thomas Scully, Authorized Signatory	03/03/2021
	WCAS XII Co-Investors LLC, By: /s/ Jonathan Rather, Authorized Signatory	03/03/2021
	WCAS Management Corporation, By: /s/ Jonathan Rather, Authorized Signatory	03/03/2021
	WCAS Co-Invest Holdco, L.P., By: /s/ Jonathan Rather, Authorized Signatory	03/03/2021
	WCAS XII Associates LLC, By: /s/ Thomas Scully, Authorized Signatory	03/03/2021
	WCAS XII Associates Cayman, L.P., By: /s/ Thomas Scully, Authorized Signatory	03/03/2021
	WCAS Co-Invest Associates LLC, By: /s/ Jonathan Rather, Authorized Signatory	03/03/2021
	** 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 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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