SEC Form 4 · accession 0001610610-17-000001
AMERICAN SHARED HOSPITAL SERVICES · AMS
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Saim Mert Ozyurek
Director
Period of report
Mar 31, 2017
Accepted (ET)
Apr 3, 2017 · 6:36 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 | Mar 31, 2017 | M | 40,000 | $2.20 | A | 81,000 | D | |
| Common StockF2 | Mar 31, 2017 | F | 20,370 | $4.32 | D | 60,630 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Warrants (right to purchase)F1 | $2.20 | Mar 31, 2017 | M | 40,000 | A | Oct 22, 2015 | Oct 22, 2017 | Common Stock | 40,000 | 0 | D |
Explanation of responses
- F1The warrants were set to expire on October 22, 2017. The warrants were exercised using a cashless settlement in accordance with the terms of the Issuer's Warrant Agreement. A cashless settlement results in the reporting person holding shares upon exercise of the warrants and obligates them to surrender a portion of the shares received upon exercise of the warrants 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 March 31, 2017.