SEC Form 4 · accession 0000731012-15-000077
HEALTHCARE SERVICES GROUP INC · HCSG
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Bryan D McCartney
Officer — Executive Vice President
Period of report
Nov 2, 2015
Accepted (ET)
Nov 4, 2015 · 7:03 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000731012
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock | Nov 2, 2015 | M | 22,500 | $10.3867 | A | 126,248 | D | |
| Common StockF1 | Nov 2, 2015 | S | 22,500 | $37.17 | D | 103,748 | D | |
| Common StockF1 | Nov 2, 2015 | A | 0 | $0.00 | A | 22,798 | I | Held by minor child |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock Option (right to buy) | $10.3867 | Nov 2, 2015 | M | 4,500 | D | Jan 5, 2010 | Jan 5, 2019 | Common Stock | 4,500 | 0 | D |
| Stock Option (right to buy) | $10.3867 | Nov 2, 2015 | M | 4,500 | D | Jan 5, 2011 | Jan 5, 2019 | Common Stock | 4,500 | 0 | D |
| Stock Option (right to buy) | $10.3867 | Nov 2, 2015 | M | 4,500 | D | Jan 5, 2012 | Jan 5, 2019 | Common Stock | 4,500 | 0 | D |
| Stock Option (right to buy) | $10.3867 | Nov 2, 2015 | M | 4,500 | D | Jan 5, 2013 | Jan 5, 2019 | Common Stock | 4,500 | 0 | D |
| Stock Option (right to buy) | $10.3867 | Nov 2, 2015 | M | 4,500 | D | Jan 5, 2014 | Jan 5, 2019 | Common Stock | 4,500 | 0 | D |
Explanation of responses
- F1Total Direct and Indirect Beneficial Ownership by Reporting Person is 126,546 shares.