SEC Form 4 · accession 0000895930-16-000159
AMSURG CORP · AMSG
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Claire M Gulmi
Officer — Executive VP & CFO · Director
Period of report
Feb 24, 2016
Accepted (ET)
Feb 26, 2016 · 5:35 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000895930
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common stockF1 | Feb 24, 2016 | M | 10,831 | $0.00 | A | 116,848 | D | |
| Common stockF2 | Feb 24, 2016 | F | 1,515 | $71.49 | D | 115,333 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Restricted stock unitsF3 | — | Feb 24, 2016 | A | 7,220 | D | — | — | Common stock | 7,220 | 5,731 | D |
Explanation of responses
- F1Each restricted stock unit converted into 1.50 shares of AmSurg Corp. common stock.
- F2Payment of tax liability by withholding securities which vested on the transaction date in accordance with rule 16b-3.
- F3Performance-based RSUs awarded on 2/3/15 that represented a contingent right to receive between 0.50 and 1.50 shares of AmSurg Corp. common stock to the extent the established performance criteria was met. Each of these RSUs converted into 1.50 shares of AmSurg Corp. common stock on February 24, 2016.