SEC Form 4 · accession 0001047335-15-000109
NATIONAL HEALTHCARE CORP · NHC
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
NATIONAL HEALTH CORP
10% Owner
Period of report
Oct 30, 2015
Accepted (ET)
Nov 3, 2015 · 5:26 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001047335
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Shares of Common Stock | Oct 30, 2015 | C | 168,616 | $0.00 | A | 1,214,763 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Shares of Series A Conv. Preferred StockF2,F1 | — | Oct 30, 2015 | C | 696,650 | D | Nov 1, 2007 | Nov 3, 2015 | Common Stock | 168,616 | 574,497 | D |
| Shares of Series A Conv. Preferred StockF3,F1 | — | Nov 3, 2015 | J | 574,497 | D | Nov 1, 2007 | Nov 3, 2015 | Common Stock | 139,051 | 0 | D |
Explanation of responses
- F1Convertable anytime at a ratio of 0.24204 Common Shares per 1.0 Preferred Share.
- F2The Filer converted 696,650 shares of Series A Preferred into Common Stock at a conversion rate of 0.24204 common shares per preferred share
- F3The reported securities were called for redemption by the issuer at a price equal to $15.79 per share.