SEC Form 4 · accession 0000899243-16-025622

USMD Holdings, Inc. · USMD

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

Reporting owner

Director

Period of report

Jul 22, 2016

Accepted (ET)

Jul 25, 2016 · 12:04 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 value)^F1	Jul 22, 2016	J	95	$3.90	A	39,541	I	Indirectly held through UANT Ventures, L.P.
Common Stock ($.01 par value)^F2	Jul 22, 2016	J	26	$2.17	D	39,515	I	Indirectly held through UANT Ventures, L.P.
Common Stock ($.01 par value)	holding	—	—		—	29,223	D

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	Owned after	D/I
Right to Purchase^F3	$23.37	holding	—	—	—	Sep 1, 2014	—	5% Convertible Subordinated Notes Due 2019	34,498	34,498	I

F1Dr. Dickey 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.
F2As reported in a Form 4 filed on May 6, 2016, Dr. Dickey acquired additional partnership interests in Ventures, which increased his indirect beneficial ownership of the shares of the issuer's common stock held by Ventures. There was an error in the calculation of the amount of partnership interests Dr. Dickey was entitled to acquire in that transaction, which resulted in Dr. Dickey's acquisition of more partnership interests in Ventures than was intended. To correct the miscalculation, on July 22, 2016, Dr. Dickey disposed of some of his partnership interests in Ventures, which decreased his indirect beneficial ownership of the issuer.
F3The 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 unpaid principal balance of the note.