0001104659-20-072002.txt : 20200610
0001104659-20-072002.hdr.sgml : 20200610
20200610160249
ACCESSION NUMBER: 0001104659-20-072002
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20200609
FILED AS OF DATE: 20200610
DATE AS OF CHANGE: 20200610
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: PORTNOY ADAM D.
CENTRAL INDEX KEY: 0001273871
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-16817
FILM NUMBER: 20954699
MAIL ADDRESS:
STREET 1: C/O THE RMR GROUP LLC
STREET 2: TWO NEWTON PL., 255 WASH. ST., STE. 300
CITY: NEWTON
STATE: MA
ZIP: 02458
FORMER NAME:
FORMER CONFORMED NAME: PORTNOY ADAM D
DATE OF NAME CHANGE: 20160607
FORMER NAME:
FORMER CONFORMED NAME: PORTNOY ADAM
DATE OF NAME CHANGE: 20031218
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: FIVE STAR SENIOR LIVING INC.
CENTRAL INDEX KEY: 0001159281
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-SKILLED NURSING CARE FACILITIES [8051]
IRS NUMBER: 043516029
STATE OF INCORPORATION: MD
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 400 CENTRE STREET
CITY: NEWTON
STATE: MA
ZIP: 02458
BUSINESS PHONE: (617) 796 8387
MAIL ADDRESS:
STREET 1: 400 CENTRE STREET
CITY: NEWTON
STATE: MA
ZIP: 02458
FORMER COMPANY:
FORMER CONFORMED NAME: FIVE STAR QUALITY CARE, INC.
DATE OF NAME CHANGE: 20161006
FORMER COMPANY:
FORMER CONFORMED NAME: FIVE STAR QUALITY CARE INC
DATE OF NAME CHANGE: 20010918
4
1
a4.xml
4
X0306
4
2020-06-09
0
0001159281
FIVE STAR SENIOR LIVING INC.
NASDAQ:FVE
0001273871
PORTNOY ADAM D.
C/O FIVE STAR SENIOR LIVING INC.,
400 CENTRE STREET
NEWTON
MA
02458
1
0
0
0
Common Stock
2020-06-09
4
A
0
5000
0
A
32332
D
Common Stock
1972783
I
See footnote
Transaction reported is grant of shares pursuant to issuer's equity compensation plan.
1,799,999 of these Common Shares are held by ABP Acquisition LLC and 172,784 of these Common Shares are held by ABP Trust. ABP Acquisition LLC is a wholly owned subsidiary of ABP Trust; Mr. Portnoy, as president, sole trustee and a beneficial owner of ABP Trust, may be deemed to be a beneficial owner of these Common Shares, but Mr. Portnoy disclaims such beneficial ownership except to the extent of his pecuniary interest therein.
/s/ Adam D. Portnoy
2020-06-10