SEC Form 4 · accession 0001144204-17-065650
Summit Healthcare REIT, Inc
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Elizabeth A. Pagliarini
Officer — Chief Financial Officer
Period of report
Nov 8, 2017
Accepted (ET)
Dec 28, 2017 · 4:52 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001310383
Table I — non-derivative securities
No Table I lines on this filing.
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Incentive Stock Option (Right to Buy)F1,F2 | $2.26 | Nov 8, 2017 | A | 17,445 | A | — | Nov 7, 2027 | Common Stock | 17,445 | 17,445 | D |
Explanation of responses
- F1The options were granted pursuant to the Summit Healthcare REIT, Inc. 2015 Omnibus Incentive Plan.
- F2The options are exercisable as follows: (a) 5,757 commencing on November 8, 2017; and (b) the remaining 11,688 in 24 equal monthly installments commencing on December 1, 2017.