0001144204-17-020876.txt : 20170418 0001144204-17-020876.hdr.sgml : 20170418 20170418134101 ACCESSION NUMBER: 0001144204-17-020876 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20161202 FILED AS OF DATE: 20170418 DATE AS OF CHANGE: 20170418 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Summit Healthcare REIT, Inc CENTRAL INDEX KEY: 0001310383 STANDARD INDUSTRIAL CLASSIFICATION: REAL ESTATE INVESTMENT TRUSTS [6798] IRS NUMBER: 731721791 STATE OF INCORPORATION: MD FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 2 SOUTH POINTE DRIVE STREET 2: STE 100 CITY: LAKE FOREST STATE: CA ZIP: 92630 BUSINESS PHONE: 949-535-2022 MAIL ADDRESS: STREET 1: 2 SOUTH POINTE DRIVE STREET 2: STE 100 CITY: LAKE FOREST STATE: CA ZIP: 92630 FORMER COMPANY: FORMER CONFORMED NAME: Cornerstone Core Properties REIT, Inc. DATE OF NAME CHANGE: 20050518 FORMER COMPANY: FORMER CONFORMED NAME: Cornerstone Core Properties REIT DATE OF NAME CHANGE: 20050516 FORMER COMPANY: FORMER CONFORMED NAME: Cornerstone Realty Fund Inc DATE OF NAME CHANGE: 20041202 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: PAGLIARINI ELIZABETH A. CENTRAL INDEX KEY: 0001618431 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-52566 FILM NUMBER: 17766621 MAIL ADDRESS: STREET 1: 2 SOUTH POINTE DR. STREET 2: SUITE 100 CITY: LAKE FOREST STATE: CA ZIP: 92630 4 1 v464433_4.xml OWNERSHIP DOCUMENT X0306 4 2016-12-02 0 0001310383 Summit Healthcare REIT, Inc NONE 0001618431 PAGLIARINI ELIZABETH A. 2 SOUTH POINTE DR., SUITE 100 LAKE FOREST CA 92630 0 1 0 0 Chief Financial Officer Incentive Stock Option (Right to Buy) 2.02 2016-12-02 4 A 0 73118 0.00 A 2026-12-01 Common Stock 73118 73118 D The options were granted pursuant to the Summit Healthcare REIT, Inc. 2015 Omnibus Incentive Plan. The options are exercisable as follows: (a) 24,373 commencing on December 2, 2016 (b) and the remaining 48,745 in 24 equal monthly installments commencing on January 1, 2016. /s/ Elizabeth Pagliarini 2017-04-18