SEC Form 4 · accession 0001032011-16-000005
AMERICAN SHARED HOSPITAL SERVICES · AMS
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
John F Ruffle
Director · 10% Owner
Period of report
Jun 21, 2016
Accepted (ET)
Jun 23, 2016 · 3:18 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000744825
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1,F2 | Jun 21, 2016 | A | 500 | $0.00 | A | 491,849 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock Options (right to buy)F3 | $2.25 | Jun 21, 2016 | A | 2,000 | A | Jun 20, 2017 | Jun 20, 2023 | Common Stock | 2,000 | 2,000 | D |
Explanation of responses
- F1This represents an award of restricted stock units. Each unit will entitle the reporting person to one share of the issuer's common stock upon vesting. The units will vest in full upon the earlier of (I) the reporting person's completion of one year of service measured from June 21, 2016, or (II) such individual's continuation in Board service through the day immediately preceding the 2017 Annual Shareholders Meeting (the "Vesting Date").
- F2Includes 500 shares subject to the reported restricted stock unit award which will vest in full on the Vesting Date.
- F3The reported stock option will vest in full upon the earlier of (I) the reporting person's completion of one year of service measured from June 21, 2016, or (II) such individual's continuation in Board service through the day immediately preceding the 2017 Annual Shareholders Meeting (the "Vesting Date").