SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
Keldie Carl J

(Last) (First) (Middle)
105 WESTPARK DRIVE, STE 200

(Street)
BRENTWOOD TN 37027

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
AMERICA SERVICE GROUP INC /DE [ ASGR ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Chief Medical Officer
3. Date of Earliest Transaction (Month/Day/Year)
06/03/2011
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 06/03/2011 D 32,439 D $26(1) 0(1) D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Employee Stock Option (right to buy) $23.31 06/03/2011 D 15,000 06/03/2011(2) 06/16/2004(2) Common Stock 15,000 $2.69(2) 0 D
Employee Stock Option (right to buy) $19.49 06/03/2011 D 12,750 06/03/2011(2) 06/15/2015(2) Common Stock 12,750 $6.51(2) 0 D
Employee Stock Option (right to buy) $14.55 06/03/2011 D 5,000 06/03/2011(2) 06/16/2016(2) Common Stock 5,000 $11.45(2) 0 D
Employee Stock Option (right to buy) $11.16 06/03/2011 D 14,999 06/03/2011(2) 06/24/2013(2) Common Stock 14,999 $14.81(2) 0 D
Employee Stock Option (right to buy) $15.33 06/03/2011 D 14,000 06/03/2011(2) 10/05/2020(2) Common Stock 14,000 $10.67(2) 0 D
Explanation of Responses:
1. Pursuant to the Agreement and Plan of Merger, Dated March 2, 2011 ("Merger Agreement") by and among America Service Group, Inc. (the "Company"), Valitas Health Services, Inc. ("Valitas") and Whiskey Acquisition Corp., a wholly-owned subsidiary of Valitas ("Merger Sub"), on June 3, 2011, Merger Sub merged with and into the Company (the "Merger"), and effective upon the consummation of the Merger each share of common stock of the Company that was issued and outstanding as of immediately prior to the effective time of the Merger was converted into the right to receive $26.00 in cash, without interest, and all restricted shares of Company common stock that were subject to vesting or forfeiture conditions (whether time-based or performance-based) that were outstanding as of immediately prior to the effective time of the Merger were fully vested immediately prior to the Merger.
2. Pursuant to the Merger Agreement, each issued and outstanding option to purchase shares of Company common stock was vested in full as of immediately prior to the Merger, and each holder of an option has the right to receive an amount in cash equal to the excess, if any, of $26.00 (without interest) over the exercise price per share of such option. Such excess is set forth in Table II, column 8.
Remarks:
Michael W. Taylor, Attorney-in-fact 06/06/2011
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
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