SEC Form 4 · accession 0000731012-18-000078
HEALTHCARE SERVICES GROUP INC · HCSG
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Theodore Wahl
Officer — President & CEO · Director
Period of report
Nov 27, 2018
Accepted (ET)
Dec 3, 2018 · 5:36 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 27, 2018 | G | 1,362 | $45.26 | A | 112,838 | D | |
| Common Stock | Nov 27, 2018 | G | 681 | $45.26 | A | 83,945 | I | Held by spouse |
| Common StockF1 | Nov 27, 2018 | G | 2,043 | $45.26 | A | 32,045 | I | Held by minor child |
| Common StockF1 | Dec 3, 2018 | G | 220 | $48.04 | D | 83,725 | I | Held by spouse |
| Common StockF1 | Dec 3, 2018 | M | 7,500 | $10.39 | A | 120,338 | 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)F2 | $10.39 | Dec 3, 2018 | M | 7,500 | D | — | Jan 5, 2019 | Common Stock | 7,500 | 0 | D |
Explanation of responses
- F1Total Direct and Indirect Beneficial Ownership by Reporting Person is 248,858.
- F2These options shall vest and become exercisable at the rate of 20% annually, commencing on the first anniversary of the January 5, 2009 grant date.