SEC Form 4 · accession 0001247524-16-000470
Surgical Care Affiliates, Inc. · SCAI
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Tom De Weerdt
Officer — Chief Financial Officer
Period of report
May 19, 2016
Accepted (ET)
May 23, 2016 · 1:50 pm EDT
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 StockF1,F2 | May 19, 2016 | F | 2,357 | $43.86 | D | 30,475 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Options to Purchase Common StockF3 | $41.25 | holding | — | — | — | — | Mar 2, 2026 | Common Stock | 13,792 | 13,792 | D |
Explanation of responses
- F1Represents shares of Common Stock withheld by the issuer to satisfy tax withholding obligations incident to the vesting and settlement on May 19, 2016 of restricted stock units of the issuer issued in accordance with Rule 16b-3 of the Securities Exchange Act of 1934, as amended (the "Exchange Act"). Such deemed disposition is exempt from Section 16(b) of the Exchange Act pursuant to Rule 16b-3(e).
- F2Includes 25,235 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: 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.
- F3The option provides for vesting in equal annual installments on March 2, 2017, March 2, 2018, March 2, 2019 and March 2, 2020.