SEC Form 4 · accession 0001179110-17-004506
American Renal Associates Holdings, Inc. · ARA
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Michael Ray Costa
Officer — VP and General Counsel
Period of report
Mar 10, 2017
Accepted (ET)
Mar 13, 2017 · 5:30 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001498068
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock | Mar 10, 2017 | A | 7,188 | $0.00 | A | 7,188 | D | |
| Common StockF2 | holding | — | — | — | 14,000 | I | See Footnote |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock Option (Right to Buy Common Stock)F2,F3 | $17.39 | Mar 10, 2017 | A | 12,000 | A | — | Mar 10, 2027 | Common Stock | 12,000 | 12,000 | I |
Explanation of responses
- F1Reflects grant of restricted stock that vests in three equal annual installments beginning on March 10, 2018.
- F2Securities held in trust for the benefit of the Reporting Person's family. The Reporting Person disclaims beneficial ownership of the shares held by such trusts, except to the extent of his pecuniary interest therein. The filing of this statement by the Reporting Person shall not be deemed to be an admission that, for purposes of Section 16 of the Securities Exchange Act of 1934 or otherwise, such Reporting Person is the beneficial owners of the securities reported therein.
- F3An option that vests in three equal annual installments beginning on March 10, 2018.