SEC Form 4 · accession 0001437749-17-004883
PROVIDENCE SERVICE CORP · PRSC
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
William Severance
Officer — Chief Accounting Officer
Period of report
Mar 15, 2017
Accepted (ET)
Mar 17, 2017 · 9:47 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001220754
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock | Mar 15, 2017 | A | 3,221 | $0.00 | A | 7,971 | D | |
| Common StockF1 | Mar 15, 2017 | A | 1,615 | $46.44 | A | 9,586 | D | |
| Common Stock | Mar 15, 2017 | F | 797 | $46.44 | D | 8,789 | 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 Option (Right to Buy)F3 | $46.44 | Mar 15, 2017 | A | 1,615 | A | Mar 15, 2020 | Mar 15, 2027 | Common Stock | 1,615 | 1,615 | D |
Explanation of responses
- F1The reporting person elected to receive these shares of the Company's common stock in lieu of a specified portion of the reporting person's annual cash bonus compensation for the 2016 fiscal year.
- F2These shares are being surrendered to the issuer by the reporting person to cover the reporting person's income tax liability associated with the common stock received by the reporting person in lieu of a specified portion of the reporting person's annual cash bonus compensation for the 2016 fiscal year.
- F3This option will become fully exercisable on 3/15/2020, subject to the reporting person's continued employment with the Company.