SEC Form 4 · accession 0001104659-18-048422
FIVE STAR SENIOR LIVING INC. · NASDAQ:FVE
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
A later amendment supersedes this filing — read the amendment. The figures below are kept as originally reported (version chain, not an overwrite).
Reporting owner
Gerard M. Martin
Director
Period of report
Jul 30, 2018
Accepted (ET)
Jul 31, 2018 · 4:41 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001159281
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | Jul 30, 2018 | G | 12,372 | $0.00 | D | 0 | I | See footnote |
| Common StockF1 | Jul 30, 2018 | G | 124 | $0.00 | A | 124 | I | See footnote |
| Common Stock | holding | — | — | — | 244,250 | D |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1The reported securities were formerly held by The Rye, Inc. On July 30, 2018, The Rye, Inc. distributed the shares of common stock of the Issuer it held to its shareholders, including 123.719 shares of common stock to The Kathleen R. Martin Non-Exempt QTIP Trust-2007, of which Mr. Martin is a trustee and beneficiary. Following these distributions, Mr. Martin may be deemed to continue to indirectly beneficially own the shares of common stock of the Issuer distributed to The Kathleen R. Martin Non-Exempt QTIP Trust-2007, but Mr. Martin disclaims such beneficial ownership except to the extent of his pecuniary interest therein.