SEC Form 4 · accession 0001209191-15-037267
USMD Holdings, Inc. · USMD
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Steven Brock
Director
Period of report
Apr 28, 2015
Accepted (ET)
Apr 30, 2015 · 11:50 am 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 | Apr 28, 2015 | A | 644 | $0.00 | A | 7,161 | D | |
| Common Stock ($.01 par) | holding | — | — | — | 34,823 | I | Indirectly held through UANT Ventures, L.P. |
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 | 5,750 | 5,750 | I |
Explanation of responses
- F1Represents stock compensation granted to the reporting person under the 2010 USMD Holdings, Inc. Equity Compensation Plan for his services as a physician employed by an affiliate of the issuer.
- 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.