0001104659-21-151668.txt : 20211220 0001104659-21-151668.hdr.sgml : 20211220 20211220160352 ACCESSION NUMBER: 0001104659-21-151668 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211216 FILED AS OF DATE: 20211220 DATE AS OF CHANGE: 20211220 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Geiger Stephen R. CENTRAL INDEX KEY: 0001876350 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-16817 FILM NUMBER: 211505249 MAIL ADDRESS: STREET 1: C/O FIVE STAR SENIOR LIVING INC. STREET 2: 400 CENTRE STREET CITY: NEWTON STATE: MA ZIP: 02458 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 tm2135795-4_4seq1.xml OWNERSHIP DOCUMENT X0306 4 2021-12-16 0 0001159281 FIVE STAR SENIOR LIVING INC. NASDAQ:FVE 0001876350 Geiger Stephen R. C/O FIVE STAR SENIOR LIVING INC., 400 CENTRE STREET NEWTON MA 02458 0 1 0 0 VP & CAO Common Stock 2021-12-16 4 F 0 1599 3.01 D 23401 D Represents payment of tax liability by withholding securities incident to the vesting of securities issued in accordance with Rule 16b-3. /s/ Stephen R. Geiger 2021-12-20