SEC Form 4 · accession 0000895930-16-000289
AMSURG CORP · AMSG
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Henry D Herr
Director
Period of report
Dec 1, 2016
Accepted (ET)
Dec 1, 2016 · 4:35 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 stockF2 | Dec 1, 2016 | D | 109,666 | — | D | 0 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 5.250% Mandatory Convertible Preferred Stock, Series A-1F2 | — | Dec 1, 2016 | D | 400 | D | — | Jul 1, 2017 | Common stock | 400 | 0 | D |
Explanation of responses
- F1Disposition pursuant to the terms of the Agreement and Plan of Merger, dated as of June 15, 2016, by and among Envision Healthcare Holdings,Inc., New Amethyst Corp. and AmSurg Corp. (the "Merger Agreement"), exempt under Rule 16b-3.
- F2Pursuant to the terms of the Merger Agreement, at the Merger 1 Effective Time (as defined in the Merger Agreement), each share of common stock or preferred stock held by the reporting person immediately prior to the Merger 1 Effective Time was assumed by New Amethyst and converted into a New Amethyst share of common stock or preferred stock having the same terms and conditions, taking into account any changes thereto by reason of the Mergers (as defined in the Merger Agreement).