0001144204-17-065650.txt : 20171228
0001144204-17-065650.hdr.sgml : 20171228
20171228165245
ACCESSION NUMBER: 0001144204-17-065650
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20171108
FILED AS OF DATE: 20171228
DATE AS OF CHANGE: 20171228
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: 171278862
MAIL ADDRESS:
STREET 1: 2 SOUTH POINTE DR.
STREET 2: SUITE 100
CITY: LAKE FOREST
STATE: CA
ZIP: 92630
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
4
1
tv482207_4.xml
OWNERSHIP DOCUMENT
X0306
4
2017-11-08
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)
2.26
2017-11-08
4
A
0
17445
0.00
A
2027-11-07
Common Stock
17445
17445
D
The options were granted pursuant to the Summit Healthcare REIT, Inc. 2015 Omnibus Incentive Plan.
The options are exercisable as follows: (a) 5,757 commencing on November 8, 2017; and (b) the remaining 11,688 in 24 equal monthly installments commencing on December 1, 2017.
/s/ Elizabeth Pagliarini
2017-12-28