SEC Form 4 · accession 0001251638-15-000003
AMERICAN SHARED HOSPITAL SERVICES · AMS
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Stanley S Trotman Jr.
Director
Period of report
May 4, 2015
Accepted (ET)
May 6, 2015 · 3:40 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 | May 4, 2015 | M | 2,000 | $2.30 | A | 327,834 | D | |
| Common StockF2 | May 4, 2015 | F | 1,723 | $2.67 | D | 326,111 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Non-Qualified Stock Options (right to buy)F1 | $2.30 | May 4, 2015 | M | 2,000 | D | Jun 19, 2009 | Jun 20, 2015 | Common Stock | 2,000 | 23,500 | D |
Explanation of responses
- F1The stock option grant was set to expire on June 20, 2015. The stock option was exercised using a cashless settlement in accordance with the terms of the Issuer's Incentive Compensation Plan as Amended and Restated Effective March 18, 2010. A cashless settlement results in the reporting person holding shares upon exercise of the stock option and obligates them to surrender a portion of the shares received upon exercise of the stock option in order to satisfy the aggregate exercise price obligation.
- F2This component of the cashless settlement reflects the shares that the reporting person was obligated to surrender to the Issuer to pay for the aggregate exercise price for the shares acquired on May 4, 2015.