SEC Form 5 · accession 0001047335-17-000020
NATIONAL HEALTHCARE CORP · NHC
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Ernest G Burgess III
Director
Period of report
Dec 31, 2016
Accepted (ET)
Feb 10, 2017 · 3:25 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 StockF1 | Nov 21, 2016 | G | 1,300 | $0.00 | D | 0 | D | |
| Shares of Common StockF1 | Nov 21, 2016 | G | 500 | $0.00 | D | 0 | D | |
| Shares of Common Stock | Nov 21, 2016 | G | 1,000 | $0.00 | D | 95,121 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Option to Purchase Common Stock | $47.45 | holding | — | — | — | May 8, 2013 | May 7, 2018 | Common Stock | 7,500 | 7,500 | D |
| Option to Purchase Common Stock | $52.93 | holding | — | — | — | May 8, 2014 | May 7, 2019 | Common Stock | 7,500 | 7,500 | D |
| Option to Purchase Common Stock | $61.25 | holding | — | — | — | May 7, 2015 | May 6, 2020 | Common Stock | 7,500 | 7,500 | D |
| Option to Purchase Common Stock | $62.78 | holding | — | — | — | Jun 2, 2016 | Jun 2, 2021 | Common Stock | 7,500 | 7,500 | D |
Explanation of responses
- F1Transaction totaled on the line below.