SEC Form 4 · accession 0001171843-15-006762

American CareSource Holdings, Inc. · GNOW

Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗

Reporting owner

Director · 10% Owner

Period of report

Dec 9, 2015

Accepted (ET)

Dec 11, 2015 · 12:53 pm EST

Rule 10b5-1 plan

unknown — predates the checkbox

Issuer CIK

0001316645

Table I — non-derivative securities

Security	Date	Code	Shares	Price	A/D	Owned after	D/I	Nature of ownership
Common Stock, par value $0.01 per share^F1	Dec 9, 2015	A	1,428,571	—	A	1,628,571	D

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	Owned after	D/I
Warrant to Purchase Common Stock^F1	$0.875	Dec 9, 2015	A	1,428,571	A	Dec 9, 2015	Dec 9, 2020	Common Stock	1,428,571	1,428,571	D

F1In connection with a public offering (the "Offering") of American CareSource Holdings, Inc. (the "Issuer"), the Reporting Person acquired 1,428,571 Class A Units (the "Units") for $0.70 per Unit, with each such Unit consisting of one share of the Issuer's common stock, par value $0.01 per share (the "Common Stock"), and a warrant to purchase one share of Common Stock with an exercise price of $0.875 (the "Warrant"). Accordingly, the Reporting Person acquired 1,428,571 shares of Common Stock and a Warrant to purchase 1,428,571 shares of Common Stock in the Offering.