SEC Form 4 · accession 0001209191-16-110966
Alliance HealthCare Services, Inc · AIQ
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Larry C. Buckelew
Director
Period of report
Mar 28, 2016
Accepted (ET)
Mar 29, 2016 · 6:53 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000817135
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | Mar 28, 2016 | M | 100,000 | $4.85 | A | 154,202 | D | |
| Common StockF2 | Mar 29, 2016 | S | 100,000 | $18.50 | D | 54,202 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Employee Stock Option (Right to Buy)F1 | $4.85 | Mar 28, 2016 | M | 100,000 | D | Jun 1, 2013 | Jun 1, 2022 | Common Stock | 100,000 | 0 | D |
Explanation of responses
- F1Gives effect to a 1-for-5 reverse split of common stock of the Issuer effected on December 26, 2012.
- F2On March 29, 2016, Fujian Thai Hot Investment Co., Ltd. ("Thai Hot"), through a wholly-owned indirect subsidiary, completed the purchase from funds managed by Oaktree Capital Management, L.P., MTS Health Investors, LLC and Larry C. Buckelew of approximately 51.5% of the outstanding shares of common stock of the Issuer (the "Transaction"). The shares reported as on this line item were disposed by Mr. Buckelew on the closing date of the Transaction.