SEC Form 5 · accession 0001371918-19-000002
Griffin-American Healthcare REIT III, Inc.
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Jeffrey T Hanson
Officer — CEO & Chairman of the Board · Director
Period of report
Dec 31, 2018
Accepted (ET)
Feb 14, 2019 · 5:58 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001566912
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | holding | — | — | — | 56,523 | D | ||
| Common StockF1,F2 | holding | — | — | — | 119,743 | I | By Hanson Family Trust DTD 6/14/2005 | |
| Common StockF3 | holding | — | — | — | 22,399 | I | By April L. Hanson IRA | |
| Common Stock | holding | — | — | — | 10,859 | I | By 401(k) Plan | |
| Common StockF4 | holding | — | — | — | 72,178 | I | By Defined Benefit Pension Plan | |
| Common StockF5 | holding | — | — | — | 4,278 | I | By NCT-107, LLC | |
| Common StockF6 | holding | — | — | — | 22,222 | I | By Griffin-American Healthcare REIT III Advisor, LLC |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1On October 30, 2018, Jeffrey T. Hanson transferred 2,348 shares of common stock to Hanson Family Trust, DTD 6/14/2005, a trust in which Mr. Hanson serves as a trustee.
- F2The reported shares of common stock are held directly by Hanson Family Trust, DTD 6/14/2005, and indirectly by Jeffrey T. Hanson and April L. Hanson, Trustees.
- F3The reported shares of common stock are owned by April L. Hanson through her investment retirement account. April L. Hanson is the wife of the reporting person.
- F4The reported shares of common stock are held directly in a defined benefit pension plan, of which Mr. Hanson serves as trustee.
- F5The reported shares of common stock are owned directly by NCT-107, LLC, a charitable foundation of which Mr. Hanson is the manager. The reporting person disclaims beneficial ownership of the reported securities except to the extent of his pecuniary interest therein, and the inclusion of these shares in this report shall not be deemed an admission of beneficial ownership of all of the reported shares for the purposes of Section 16 or for any other purpose.
- F6The reported shares of common stock are owned by Griffin-American Healthcare REIT III Advisor, LLC ("GAHRIII Advisor"). Mr. Hanson serves as a managing director of American Healthcare Investors, LLC, the managing member of GAHRIII Advisor, and as such, may be deemed to be the beneficial owner of such common stock. Mr. Hanson disclaims beneficial ownership of the reported securities except to the extent of his pecuniary interest therein.