SEC Form 4 · accession 0000731012-17-000092
HEALTHCARE SERVICES GROUP INC · HCSG
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Diane S Casey
Director
Period of report
Aug 14, 2017
Accepted (ET)
Aug 17, 2017 · 8:16 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 | Aug 14, 2017 | M | 1,000 | $17.50 | A | 1,000 | D | |
| Common Stock | Aug 14, 2017 | M | 1,000 | $23.50 | A | 2,000 | D | |
| Common Stock | Aug 14, 2017 | M | 1,000 | $28.02 | A | 3,000 | D | |
| Common Stock | Aug 14, 2017 | M | 1,000 | $30.30 | A | 4,000 | D | |
| Common Stock | Aug 14, 2017 | M | 1,001 | $34.14 | A | 5,001 | D | |
| Common Stock | Aug 14, 2017 | S | 5,001 | $51.00 | D | 0 | 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)F1 | $17.50 | Aug 14, 2017 | M | 1,000 | D | Jan 5, 2017 | Jan 5, 2022 | Common Stock | 1,000 | 0 | D |
| Stock Option (right to buy)F2 | $23.50 | Aug 14, 2017 | M | 1,000 | D | Jan 4, 2018 | Jan 4, 2023 | Common Stock | 1,000 | 1,000 | D |
| Stock Option (right to buy)F3 | $28.02 | Aug 14, 2017 | M | 1,000 | D | Jan 3, 2019 | Jan 3, 2024 | Common Stock | 1,000 | 2,000 | D |
| Stock Option (right to buy)F4 | $30.30 | Aug 14, 2017 | M | 1,000 | D | Jan 5, 2020 | Jan 5, 2025 | Common Stock | 1,000 | 3,000 | D |
| Stock Option (right to buy)F5 | $34.14 | Aug 14, 2017 | M | 1,001 | D | Jan 4, 2021 | Jan 4, 2026 | Common Stock | 1,001 | 4,000 | D |
Explanation of responses
- F1These options shall vest and become exercisable at the rate of 20% annually, commencing on the first anniversary of the January 5, 2012 grant date.
- F2These options shall vest and become exercisable at the rate of 20% annually, commencing on the first anniversary of the January 4, 2013 grant date.
- F3These options shall vest and become exercisable at the rate of 20% annually, commencing on the first anniversary of the January 3, 2014 grant date.
- F4These options shall vest and become exercisable at the rate of 20% annually, commencing on the first anniversary of the January 5, 2015 grant date.
- F5These options shall vest and become exercisable at the rate of 20% annually, commencing on the first anniversary of the January 4, 2016 grant date.