SEC Form 4 · accession 0000899243-15-001101

USMD Holdings, Inc. · USMD

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

Reporting owner

Director

Period of report

Jul 9, 2015

Accepted (ET)

Jul 13, 2015 · 1:39 pm EDT

Rule 10b5-1 plan

unknown — predates the checkbox

Issuer CIK

0001507881

Table I — non-derivative securities

Security	Date	Code	Shares	Price	A/D	Owned after	D/I	Nature of ownership
Common Stock ($.01 par)^F1	Jul 9, 2015	A	6,343	$8.40	A	13,132	D
Common Stock ($.01 par)	holding	—	—		—	120,623	I	Indirectly held through UANT Ventures, L.P.
Common Stock ($.01 par)	holding	—	—		—	13,248	I	Held in M. Patrick Collini, MD, P.A

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	Owned after	D/I
Options to Purchase	$24.84	holding	—	—	—	Aug 31, 2012	Aug 31, 2017	Common Stock ($.01 par)	1,745	1,745	I
7.25% Convertible Subordinated Notes due 2020^F2	$10.61	holding	—	—	—	Apr 29, 2016	—	Common Stock ($.01 par)	18,850	18,850	D

F1Represents stock compensation granted to the reporting person under the 2010 USMD Holdings, Inc. Equity Compensation Plan for his services as a physician employed by an affiliate of the issuer.
F2The noteholder has the right, at any time after April 29, 2016 but prior to the payment in full of the note by the issuer, to convert all or any portion of the unpaid principal balance of the note into shares of the issuer's common stock. This conversion right expires on November 1, 2020, the maturity date of the note, or upon the earlier payment in full of of the principal balance of the note.