SEC Form 5 · accession 0001437749-15-000621
ExamWorks Group, Inc. · EXAM
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
William A Shutzer
Director
Period of report
Dec 31, 2014
Accepted (ET)
Jan 13, 2015 · 4:44 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001498021
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock | Dec 18, 2014 | G | 8,350 | $0.00 | D | 360,340 | D | |
| Common StockF1 | holding | — | — | — | 12,453 | I | by Shutzer Family Limited Partnership | |
| Common StockF2 | holding | — | — | — | 82,185 | I | by Article IV Trust F/B/O Katherine Brennan | |
| Common StockF3 | holding | — | — | — | 75,957 | I | by Article IV Trust F/B/O James Lampert Shutzer | |
| Common StockF4 | holding | — | — | — | 82,185 | I | by Article IV Trust F/B/O Christopher David Shutzer | |
| Common StockF5 | holding | — | — | — | 75,958 | I | by Article IV Trust F/B/O Megan Anne Shutzer |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1The reporting person's wife is a general partner of the Shutzer Family Limited Partnership.
- F2The reporting person's wife is the trustee of Article IV Trust F/B/O Katherine Brennan.
- F3The reporting person's wife is the trustee of Article IV Trust F/B/O James Lampert Shutzer.
- F4The reporting person's wife is the trustee of Article IV Trust F/B/O Christopher David Shutzer.
- F5The reporting person's wife is the trustee of Article IV Trust F/B/O Megan Anne Shutzer.