SEC Form 4 · accession 0001247524-16-000370

Surgical Care Affiliates, Inc. · SCAI

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

Reporting owner

Officer — Chief Financial Officer

Period of report

Mar 2, 2016

Accepted (ET)

Mar 4, 2016 · 6:16 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 Stock^F1,F2	Mar 2, 2016	A	10,667	$0.00	A	32,832	D

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	Owned after	D/I
Options to Purchase Common Stock^F4	$41.25	Mar 2, 2016	A	13,792	A	—	Mar 2, 2026	Common Stock	13,792	13,792	D

F1Grant of restricted stock units of the issuer, vesting ratably in equal annual installments over a period of four years from March 2, 2016, pursuant to the Surgical Care Affiliates, Inc. 2013 Omnibus Long-Term Incentive Plan (as amended), which is exempt under Rule 16b-3(d) of the Securities Exchange Act of 1934, as amended.
F2Includes 32,519 shares of Common Stock underlying restricted stock units ("RSUs") of the issuer. All of the RSUs are subject to time-based vesting and vest on the following schedule: 7,284 RSUs vesting on May 19, 2016, 2,667 RSUs vesting on March 2, 2017, 7,284 RSUs vesting on May 19, 2017, 2,667 RSUs vesting on March 2, 2018, 7,284 RSUs vesting on May 19, 2018, 2,667 RSUs vesting on March 2, 2019 and 2,666 RSUs vesting on March 2, 2020.
F3Grant of options to purchase shares of Common Stock of the issuer pursuant to the Surgical Care Affiliates, Inc. 2013 Omnibus Long-Term Incentive Plan (as amended), which is exempt under Rule 16b-3(d) of the Securities Exchange Act of 1934, as amended.
F4The option provides for vesting in equal annual installments on March 2, 2017, March 2, 2018, March 2, 2019 and March 2, 2020.