SEC Form 4 · accession 0000899243-15-010132
USMD Holdings, Inc. · USMD
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Michael W. Bukosky
Officer — Chief Administraive Officer
Period of report
Dec 16, 2015
Accepted (ET)
Dec 18, 2015 · 3:32 pm EST
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 ($0.01 par)F1 | Dec 16, 2015 | A | 2,474 | $7.20 | A | 7,819 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Option to PurchaseF2 | $15.54 | holding | — | — | — | — | Mar 7, 2022 | Common Stock ($0.01 par) | 100,000 | 100,000 | D |
Explanation of responses
- F1Represents stock compensation issued pursuant to the USMD Salary Deferral Plan and granted to Mr. Bukosky in lieu of cash compensation of $17,813 for his services as Chief Administrative Officer.
- F2Mr. Bukosky was awarded options to purchase 100,000 shares of common stock under the 2010 USMD Holdings, Inc. Equity Compensation Plan. Options for 20,000 shares vested on March 7, 2014 and options for an additional 20,000 shares vested on January 1, 2015. The remaining options will vest at a rate of 20,000 shares per year on the first day of each calendar year until fully vested.