SEC Form 4 · accession 0001140361-16-048182
Community Healthcare Trust Inc · CHCT
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
A later amendment supersedes this filing — read the amendment. The figures below are kept as originally reported (version chain, not an overwrite).
Reporting owner
Timothy G Wallace
Officer — Chairman, CEO and President · Director
Period of report
Jan 15, 2016
Accepted (ET)
Jan 20, 2016 · 4:04 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001631569
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock | Jan 15, 2016 | A | 33,665 | $0.00 | A | 157,781 | D | |
| Common StockF1 | holding | — | — | — | 120,000 | I | See Footnote (1) |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1The amount shown represents the beneficial ownership of the Issuer's securities by Athena Funding Partners, LLC ("AFP"). Mr. Wallace owns 99% of AFP and disclaims beneficial ownership of the securities to the extent it exceeds his pecuniary interest therein and the inclusion of the shares in this report shall not be deemed to be an admission of beneficial ownership of the reported shares for the purposes of Section 16 of the Exchange Act or otherwise.