0001433671-17-000013.txt : 20170711 0001433671-17-000013.hdr.sgml : 20170711 20170711131239 ACCESSION NUMBER: 0001433671-17-000013 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170707 FILED AS OF DATE: 20170711 DATE AS OF CHANGE: 20170711 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Griffin-American Healthcare REIT IV, Inc. CENTRAL INDEX KEY: 0001632970 STANDARD INDUSTRIAL CLASSIFICATION: REAL ESTATE INVESTMENT TRUSTS [6798] IRS NUMBER: 472887436 STATE OF INCORPORATION: MD FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 18191 VON KARMAN AVENUE STREET 2: SUITE 300 CITY: IRVINE STATE: CA ZIP: 92612 BUSINESS PHONE: 949-270-9200 MAIL ADDRESS: STREET 1: 18191 VON KARMAN AVENUE STREET 2: SUITE 300 CITY: IRVINE STATE: CA ZIP: 92612 FORMER COMPANY: FORMER CONFORMED NAME: Griffin-American Healthcare REIT 4, Inc. DATE OF NAME CHANGE: 20150428 FORMER COMPANY: FORMER CONFORMED NAME: Griffin-American Healthcare REIT IV, Inc. DATE OF NAME CHANGE: 20150205 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Prosky Danny CENTRAL INDEX KEY: 0001433671 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-55775 FILM NUMBER: 17959522 MAIL ADDRESS: STREET 1: 18191 VON KARMAN AVENUE STREET 2: SUITE 300 CITY: IRVINE STATE: CA ZIP: 92612 4 1 wf-form4_149979314550158.xml FORM 4 X0306 4 2017-07-07 0 0001632970 Griffin-American Healthcare REIT IV, Inc. NONE 0001433671 Prosky Danny C/O GRIFFIN-AMERICAN HEALTHCARE REIT IV, INC., 18191 VON KARMAN AVE., STE. 300 IRVINE CA 92612 0 1 0 0 President & COO Class I Common Stock 2017-07-07 4 P 0 1235 9.21 A 13948 I By Danny and Zohar Prosky Family Rev Trust UA DTD 08/16/2011 Class T Common Stock 48339 I By Danny and Zohar Prosky Family Rev Trust UA DTD 08/16/2011 Class T Common Stock 20833 I By Griffin-American Healthcare REIT IV Advisor, LLC The reported shares of Class I Common Stock were acquired at $9.21 per share by Mr. Prosky pursuant to an Executive Stock Purchase Plan between Mr. Prosky and the Issuer, entered into on 12/30/2016. The reported shares of Class I common stock are held directly by Danny & Zohar Prosky Family Rev Trust UA DTD 08/16/2011, and indirectly by Danny Prosky and Zohar Prosky, Trustees. The reported shares of Class T common stock are held directly by Danny & Zohar Prosky Family Rev Trust UA DTD 08/16/2011, and indirectly by Danny Prosky and Zohar Prosky, Trustees. The reported shares of Class T common stock are owned by Griffin-American Healthcare REIT IV Advisor, LLC ("GAHRIV Advisor"). Mr. Prosky serves as a managing director of American Healthcare Investors, LLC, the managing member of GAHRIV Advisor, and as such, may be deemed to be the beneficial owner of such common stock. Mr. Prosky disclaims beneficial ownership of the reported securities except to the extent of his pecuniary interest therein. /s/ DANNY PROSKY 2017-07-11