SEC Form 5 · accession 0001247524-16-000338
Surgical Care Affiliates, Inc. · SCAI
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Thomas C Geiser
Director
Period of report
Dec 31, 2015
Accepted (ET)
Jan 27, 2016 · 12:25 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001411574
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF2 | Nov 19, 2015 | G | 27,777 | $0.00 | D | 69,783 | I | See Explanation of Responses |
| Restricted Stock UnitsF1 | holding | — | — | — | 8,328 | D |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1All of the Restricted Stock Units ("RSUs") are subject to time-based vesting. As of December 31, 2015, 5,204 of the RSUs were vested, with the remaining RSUs vesting on the following schedule: 978 RSUs vesting on June 4, 2016, 1,168 RSUs vesting on June 30, 2016 and 978 RSUs vesting on June 4, 2017. Each vested RSU is settled on the earlier of the individual's termination of employment (as defined in the Plan) or a change in control.
- F2Mr. Geiser is a trustee of The Geiser Schweers Family Trust u/a/d 6/8/98, as amended, which is the sole member of TDK Management Company, LLC, which is the general partner of TDK Properties, L.P., which directly owns 69,783 shares of Common Stock of the issuer.