SEC Form 4 · accession 0000899243-16-019381
USMD Holdings, Inc. · USMD
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Russell A. Dickey
Director
Period of report
May 4, 2016
Accepted (ET)
May 6, 2016 · 2:06 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 | May 4, 2016 | J | 957 | $2.17 | A | 39,446 | I | Indirectly held through UANT Ventures, L.P. |
| Common Stock ($.01 par) | holding | — | — | — | 29,233 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Right to purchaseF2 | $23.37 | holding | — | — | — | Sep 1, 2014 | — | 5% Convertible Subordinated Notes Due 2019 | 34,498 | 34,498 | I |
Explanation of responses
- F1Dr. Dickey purchased additional partnership interests in UANT Ventures, LP ("Ventures"), which resulted in an increase in his indirect beneficial ownership of the shares of the issuer's common stock held by Ventures.
- F2The 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.