SEC Form 4 · accession 0001047335-15-000124
NATIONAL HEALTHCARE CORP · NHC
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Robert Michael Ussery
Officer — Chief Operating Officer
Period of report
Nov 3, 2015
Accepted (ET)
Nov 4, 2015 · 12:05 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 in name of child | Nov 2, 2015 | C | 13 | $0.00 | A | 48 | D | |
| Shares of Common Stock owned by myself & spouse | holding | — | — | — | 110,905 | 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 StockF3,F1 | — | Nov 2, 2015 | C | 56 | D | Nov 1, 2007 | Nov 3, 2015 | Common Stock | 13 | 37,201 | D |
| Shares of Series A Convertible Preferred StockF2,F1 | — | Nov 3, 2015 | J | 37,201 | D | Nov 1, 2007 | Nov 3, 2015 | Common Stock | 9,017 | 0 | D |
| Option to purchase Common Stock | $46.69 | holding | — | — | — | Dec 4, 2012 | Feb 29, 2016 | Common Stock | 37,000 | 32,500 | D |
Explanation of responses
- F1Convertible anytime at a ratio of 0.24204 common shares per 1.0 preferred share.
- F2The reported securities were called for redemption by the issuer at a price equal to $15.79 per share.
- F3The Filer convered 56 shares of Series A Preferred into Common Stock at the conversion rate of 0.24204 common shares per preferred share.