SEC Form 4 · accession 0000075252-16-000218
ACCENDRA HEALTH INC/VA/ · ACH
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Lemuel E Lewis
Director
Period of report
Oct 27, 2016
Accepted (ET)
Oct 31, 2016 · 10:11 am EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000075252
Table I — non-derivative securities
No Table I lines on this filing.
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Phantom StockF1 | — | Oct 27, 2016 | A | 108 | A | — | — | Common Stock | 108 | 31,933 | D |
| Phantom StockF1 | — | Oct 28, 2016 | A | 62 | A | — | — | Common Stock | 62 | 31,995 | D |
Explanation of responses
- F1The shares of phantom stock are convertible on a 1-for-1 basis and become payable, in cash or common stock, at the election of the reporting person, upon the occurrence of one of the following (as elected in advance by the reporting person): (a) death, (b) disability, (c) termination of service as director, (d) specified future delivery date, or (e) the earliest to occur of (a), (b), (c) or (d).