SEC Form 4 · accession 0001209191-15-041637
COMMUNITY HEALTH SYSTEMS INC · CYH
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
James S. Ely III
Director
Period of report
May 11, 2015
Accepted (ET)
May 12, 2015 · 4:13 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001108109
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock | May 11, 2015 | G | 4,990 | $0.00 | D | 20,227 | D | |
| Common Stock | May 11, 2015 | G | 4,990 | $0.00 | A | 4,990 | I | By E5 Investors LLC |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Restricted Stock Units | $0.00 | holding | — | — | — | Feb 27, 2014 | Feb 26, 2023 | Common Stock | 1,198 | 1,198 | D |
| Restricted Stock Units | $0.00 | holding | — | — | — | Mar 1, 2015 | Feb 29, 2024 | Common Stock | 2,409 | 2,409 | D |
| Restricted Stock Units | $0.00 | holding | — | — | — | Mar 1, 2016 | Feb 28, 2025 | Common Stock | 3,504 | 3,504 | D |
| Stock Units (SU)F2 | $0.00 | holding | — | — | — | — | — | Common Stock | 574 | 574 | D |
Explanation of responses
- F1Transfer of shares beneficially owned by Reporting Person to E5 Investors LLC, a Florida limited liability company, owned 20% by Reporting Person, 20% by Reporting Person's spouse, and 60% by family members of Reporting Person who do not share Reporting Person's household. Reporting Person and Reporting Person's spouse serve as managers of E5 Investors LLC. The Reporting Person disclaims beneficial ownership of the Company's common stock held by E5 Investors LLC except to the extent of his pecuniary interest therein.
- F2The Stock Units were accrued under the Company's Directors' Fees Deferral Plan and are settled 100% in the Company's common stock upon cessation as a director or upon a date specified by the director.