SEC Form 4 · accession 0001609580-15-000004
AMERICAN SHARED HOSPITAL SERVICES · AMS
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Raymond C Stachowiak
Director · 10% Owner
Period of report
Jul 7, 2015
Accepted (ET)
Jul 14, 2015 · 7:13 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 Stock, No Par Value | Jul 7, 2015 | G | 400,000 | $0.00 | D | 155,500 | I | By RCS Investments Inc. |
| Common Stock, No Par ValueF1 | Jul 7, 2015 | G | 400,000 | $0.00 | A | 400,000 | I | By Stachowiak Equity Fund LLC |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1Fund is 60% controlled by a trust with the reporting person as sole trustee and beneficiary, and 20% each by two trusts established for the benefit of the reporting person's children, with the spouse of the reporting person as sole trustee of each.