SEC Form 4/A · accession 0001140361-16-054935
Community Healthcare Trust Inc · CHCT
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
This is an amendment (Form 4/A). It replaces an earlier filing for the same period.
Reporting owner
Timothy G Wallace
Officer — Chairman, CEO and President · Director
Period of report
Jan 15, 2016
Accepted (ET)
Feb 25, 2016 · 6:04 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 StockF1 | Jan 15, 2016 | A | 33,665 | $17.823 | A | 157,781 | D | |
| Common StockF2 | holding | — | — | — | 120,000 | I | See Footnote (2) |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1For 2016, the reporting person agreed to take 100% of his salary in the form of shares of restricted stock with an eight-year restriction period. Because the reporting person elected to take his base salary for 2016 in these shares of restricted stock, the Company awarded Mr. Wallace additional compensation, in restricted stock, equal to his annual salary. The price of the securities acquired by the reporting person is based on the volume weighted average price of the Company's common stock for the 10 trading days immediately preceding January 15, 2016, which was $17.823. The number of securities issued is equal to the total salary, including the additional compensation, divided by such price.
- F2The amount shown represents the beneficial ownership of the Company's securities by Athena Funding Partners, LLC ("AFP"). The reporting person 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.