SEC Form 4 · accession 0000899243-16-010868

USMD Holdings, Inc. · USMD

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

Reporting owner

Director

Period of report

Dec 31, 2015

Accepted (ET)

Jan 5, 2016 · 5:19 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 ($.01 par)^F1	Dec 31, 2015	J	9,438	$7.00	A	140,930	I	Indirectly held through UANT Ventures, L.P.
Common Stock ($.01 par)^F2	Dec 31, 2015	J	69	$21.99	A	140,999	I	Indiectly held through UANT Ventures, L.P.
Common Stock ($.01 par)	holding	—	—		—	27,407	D

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	Owned after	D/I
7.25% Convertible Subordinated Note due 2020^F3	$10.61	holding	—	—	—	Apr 29, 2016	—	Common Stock ($.01 par)	23,563	23,563	D

F1Dr. Cook purchased additional partnership interests in UANT Ventures, L.P. ("Ventures"), which resulted in an increase in his indirect beneficial ownership of the shares of the issuer's common stock held by Ventures.
F2Ventures reallocated certain of its partnership interests among its partners based upon the results of a capital call. Dr. Cook received additional partnership interests as a result of this reallocation, which resulted in an increase in his indirect beneficial ownership of the shares of the issuer's common stock held by Ventures.
F3The 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.