SEC Form 4 · accession 0001247524-16-000382

Surgical Care Affiliates, Inc. · SCAI

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

Reporting owner

Director

Period of report

Mar 2, 2016

Accepted (ET)

Mar 4, 2016 · 6:28 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	2,182	$0.00	A	10,510	D

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	Owned after	D/I
Options to Purchase Common Stock^F3	$12.10	holding	—	—	—	—	Aug 1, 2021	Common Stock	9,921	9,921	D

F1Grant of restricted stock units of the issuer, vesting ratably in equal annual installments over a period of two years from March 2, 2016, pursuant to the Surgical Care Affiliates, Inc. 2013 Omnibus Long-Term Incentive Plan (as amended, the "Plan"), which is exempt under Rule 16b-3(d) of the Securities Exchange Act of 1934, as amended.
F2Includes 10,510 shares of Common Stock underlying restricted stock units ("RSUs") of the issuer, all of which are subject to time-based vesting. As of the date hereof, 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, 1,091 RSUs vesting on March 2, 2017, 978 RSUs vesting on June 4, 2017 and 1,091 RSUs vesting on March 2, 2018. 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 of the issuer.
F3The options became vested as to all of the shares of Common Stock underlying such options on June 29, 2012 and became exercisable on September 16, 2013.