UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
SCHEDULE 13G
Under the Securities Exchange Act of 1934
(Amendment No. __)*
Check the appropriate box to designate the rule pursuant to which this Schedule is filed:
o Rule 13d-1(b)
o Rule 13d-1(c)
þ Rule 13d-1(d)
* The remainder of this cover page shall be filled out for a reporting persons initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter the disclosures provided in a prior cover page.
The information required in the remainder of this cover page shall not be deemed to be filed for the purpose of Section 18 of the Securities Exchange Act of 1934 (Act) or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however, see the Notes).
CUSIP No. |
60855R100 |
Page | 1 |
of | 4 |
1 | NAME OF REPORTING PERSON I.R.S. IDENTIFICATION NO. OF ABOVE PERSON Molina Siblings Trust |
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2 | CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (SEE INSTRUCTIONS) |
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(a) o | |||||
(b) þ | |||||
3 | SEC USE ONLY | ||||
4 | CITIZENSHIP OR PLACE OF ORGANIZATION | ||||
United States | |||||
5 | SOLE VOTING POWER | ||||
NUMBER OF | 3,329,359 | ||||
SHARES | 6 | SHARED VOTING POWER | |||
BENEFICIALLY | |||||
OWNED BY | 0 | ||||
EACH | 7 | SOLE DISPOSITIVE POWER | |||
REPORTING | |||||
PERSON | 3,329,359 | ||||
WITH: | 8 | SHARED DISPOSITIVE POWER | |||
0 | |||||
9 | AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON | ||||
3,329,359 | |||||
10 | CHECK IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES (SEE INSTRUCTIONS) | ||||
o | |||||
11 | PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9) | ||||
11.7% | |||||
12 | TYPE OF REPORTING PERSON (SEE INSTRUCTIONS) | ||||
IN |
Page | 2 |
of | 4 |
Item 1(a). | Name of Issuer: MOLINA HEALTHCARE, INC. |
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Item 1(b). | Address of Issuers Principal Executive Offices: 200 Oceangate, Suite 100, Long Beach, CALIFORNIA 90802 |
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Item 2(a). | Name of Persons Filing: Molina Siblings Trust |
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Item 2(b). | Address of Principal Business Office or, if none, Residence: 3300 Douglas Blvd., Suite 430 Roseville, CA 95661 |
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Item 2(c). | Citizenship: United States |
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Item 2(d). | Title of Class of Securities: Common Stock, $0.001 par value |
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Item 2(e). | CUSIP Number: 60855R100 |
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Item 3. | If this statement is filed pursuant to Rules 13d-1(b) or 13d-2(b) or (c), check whether the person filing is a: | |||||
(a).o | Broker or dealer registered under Section 15 of the Act (15 U.S.C. 780). | |||||
(b).o | Bank as defined in Section 3(a)(6) of the Act (15 U.S.C. 78c). | |||||
(c).o | Insurance company as defined in Section 3(a)(19) of the Act (15 U.S.C. 78c). | |||||
(d).o | Investment company registered under Section 8 of the Investment Company Act of 1940 (15 U.S.C. 80a-8). | |||||
(e).o | An investment adviser in accordance with Rule 13d-1(b)(1)(ii)(E); | |||||
(f).o | An employee benefit plan or endowment fund in accordance with Rule 13d-1(b)(1)(ii)(F); | |||||
(g).o | A parent holding company or control person in accordance with Rule 13d-1(b)(1)(ii)(G); | |||||
(h).o | A savings association as defined in Section 3(b) of the Federal Deposit Insurance Act (12 U.S.C. 1813); | |||||
(i).o | A church plan that is excluded from the definition of an investment company under Section 3(c)(14) of the Investment Company Act of 1940 (15 U.S.C. 80a-3); | |||||
(j).o | Group, in accordance with Rule 13d-1(b)(1)(ii)(J). |
Page | 3 |
of | 4 |
Item 4.
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Ownership. | |||||
(a). | Amount beneficially owned: See the response(s) to Item 9 on the attached cover page(s). |
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(b). | Percent of Class: See the response(s) to Item 11 on the attached cover page(s). |
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(c). | Number of shares as to which such person has: | |||||
(i). | Sole power to vote or to direct the vote: See the response(s) to Item 5 on the attached cover page(s). | |||||
(ii). | Shared power to vote or to direct the vote: See the response(s) to Item 6 on the attached cover page(s). | |||||
(iii). | Sole power to dispose or to direct the disposition of: See the response(s) to Item 7 on the attached cover page(s). | |||||
(iv). | Shared power to dispose or to direct the disposition of: See the response(s) to Item 8 on the attached cover page(s). | |||||
Item 5. | Ownership of Five Percent or Less of a Class. If this statement is being filed to report the fact that as of the date hereof the reporting persons have ceased to be the beneficial owners of more than five percent of the class of securities, check the following o. |
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Item 6. | Ownership of More than Five Percent on Behalf of Another Person. Not Applicable |
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Item 7. | Identification and Classification of the Subsidiary Which Acquired the Security
Being Reported on by the Parent Holding Company. Not Applicable |
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Item 8. | Identification and Classification of Members of the Group. Not Applicable |
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Item 9. | Notice of Dissolution of Group. Not Applicable |
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Item 10. | Certification. Not Applicable |
Page | 4 |
of | 4 |
Molina Siblings Trust |
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By: | /s/ John C. Molina | |||
Name: | John C. Molina | |||
Title: | Trustee | |||