SEC Form 4 · accession 0001171843-15-005039
American CareSource Holdings, Inc. · GNOW
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
John Pappajohn
Officer — Acting Chief Executive Officer · Director
Period of report
Sep 2, 2015
Accepted (ET)
Sep 4, 2015 · 5:06 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001316645
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Warrant to Purchase Common Stock, par value $0.01 per shareF2,F1 | $1.70 | Sep 2, 2015 | A | 150,000 | A | — | Aug 12, 2020 | Common Stock | 150,000 | 150,000 | D |
Explanation of responses
- F1Warrants are exercisable immediately.
- F2Issued in consideration for providing a guarantee to a lender of up to $500,000 for an extension to an existing line of credit rendered to the company.