SEC Form 4 · accession 0001185185-17-001820
PACIFIC HEALTH CARE ORGANIZATION INC · PFHO
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Fred U Odaka
Officer — Chief Financial Officer
Period of report
Aug 17, 2017
Accepted (ET)
Aug 21, 2017 · 5:00 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001138476
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common | holding | — | — | — | 750 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Employee Stock OptionsF1,F2 | $15.00 | Aug 17, 2017 | A | 11,000 | A | — | Aug 17, 2022 | Common Stock | 11,000 | 11,000 | D |
Explanation of responses
- F1On August 17, 2017, the Reporting Person was granted nonqualified stock options to purchase 11,000 shares of the Issuer's common stock pursuant to the Issuer's 2005 Stock Option Plan.
- F2The options do not vest for a period of one year from the Transaction Date. Vesting is subject to the Reporting Person remaining continuously employed with the Company until the one-year anniversary of the Transaction Date, except in the event the Reporting Person's employment terminates as a result of death or disability, in which case, the options shall vest to the designated beneficiary of the Reporting Person on the one-year anniversary of the Transaction Date. Vested options become exercisable on the one-year anniversary of the Transaction Date.