SEC Form 4 · accession 0001171843-16-007284
American CareSource Holdings, Inc. · GNOW
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Adam Sidney Winger
Officer — See Remarks
Period of report
Jan 18, 2016
Accepted (ET)
Jan 20, 2016 · 4:26 pm EST
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock option (right to buy)F1 | $0.26 | Jan 18, 2016 | A | 300,000 | A | — | Jan 18, 2026 | Common Stock | 300,000 | 300,000 | D |
| Stock option (right to buy)F2 | $0.26 | Jan 18, 2016 | A | 300,000 | A | — | Jan 18, 2016 | Common Stock | 300,000 | 300,000 | D |
| Restricted Stock UnitsF3,F4 | — | Jan 18, 2016 | A | 200,000 | A | — | — | Common Stock | 200,000 | 200,000 | D |
Explanation of responses
- F1The stock option vests as follows: (i) the option to purchase 60,000 shares of common stock of the Issuer, par value $0.01 per share (the "Common Stock"), vests on January 18, 2017 and (ii) the option for the remaining 240,000 shares of Common Stock vests in equal monthly installments over the 48 months immediately following January 18, 2017.
- F2The stock option vests in one-third increments upon the attainment of certain operational and financial milestones of the Issuer.
- F3Each Restricted Stock Unit represents a contingent right to receive one share of Common Stock.
- F4The Restricted Stock Units vest in equal monthly installments beginning on February 1, 2016 and the first day of each of the 35 months immediately thereafter.
Remarks
President, Chief Executive Officer, Secretary and Interim Chief Financial Officer