SEC Form 4 · accession 0000731012-17-000050
HEALTHCARE SERVICES GROUP INC · HCSG
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
John Briggs
Director
Period of report
Apr 25, 2017
Accepted (ET)
Apr 27, 2017 · 9:01 pm EDT
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 | Apr 25, 2017 | M | 3,774 | $14.3067 | A | 24,809 | D | |
| Common StockF1 | Apr 25, 2017 | F | 1,159 | $46.62 | D | 23,650 | D | |
| Common Stock | Apr 25, 2017 | M | 1,226 | $16.11 | A | 24,876 | D | |
| Common StockF1 | Apr 25, 2017 | F | 424 | $46.62 | D | 24,452 | D |
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) | $14.3067 | Apr 25, 2017 | M | 3,774 | D | Jan 4, 2015 | Jan 4, 2020 | Common Stock | 3,774 | 0 | D |
| Stock Option (right to buy) | $16.11 | Apr 25, 2017 | M | 1,226 | D | Jan 6, 2016 | Jan 6, 2021 | Common Stock | 1,226 | 3,775 | D |
Explanation of responses
- F1Transaction represents withholding of shares based on a net exercise to satisfy the cost to exercise the options.