SEC Form 4 · accession 0000899243-15-006475

USMD Holdings, Inc. · USMD

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

Reporting owner

Director

Period of report

Jan 31, 2015

Accepted (ET)

Oct 8, 2015 · 5:53 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	Jan 31, 2015	A	288	$15.04	A	18,169	D
Common Stock ($.01 par)^F1	Feb 28, 2015	A	303	$13.74	A	18,472	D
Common Stock ($.01 par)^F1	Mar 31, 2015	A	355	$10.44	A	18,827	D
Common Stock ($.01 par)^F1	Jun 30, 2015	A	1,486	$8.48	A	20,313	D
Common Stock ($.01 par)^F1	Sep 30, 2015	A	1,673	$7.20	A	21,986	D
Common Stock ($.01 par)^F2	Oct 6, 2015	A	5,618	$9.06	A	27,604	D
Common Stock ($.01 par)^F3	Oct 7, 2015	A	37	$1.00	A	33,879	I	Indirectly held through UANT Ventures, L.P.

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	Owned after	D/I
Right to purchase^F4	$23.37	holding	—	—	—	Sep 1, 2014	—	5% Convertible Subordinated Notes Due 2019	34,498	34,498	I

F1Represents stock compensation granted to reporting person under the 2010 USMD Holdings, Inc. Equity Compensation Plan for his services as a director for the period from January 2015 through September 2015.
F2Represents stock compensation granted to reporting person under the 2010 USMD Holdings, Inc. Equity Compensation Plan for his services as a physician employed by an affiliate of the issuer.
F3Dr. Dickey purchased additional partnership interests in UANT Ventures, L.P., which resulted in an increase in his indirect beneficial ownership of the shares of the issuer's common stock held by UANT Ventures, L.P.
F4The noteholder has the right at any time prior to the payment in full of the note, 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 March 1, 2019, the maturity date of the note, or upon the earlier payment in full of the principal balance of the note.