0000903423-13-000577.txt : 20131030 0000903423-13-000577.hdr.sgml : 20131030 20131030191009 ACCESSION NUMBER: 0000903423-13-000577 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20131030 FILED AS OF DATE: 20131030 DATE AS OF CHANGE: 20131030 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Surgical Care Affiliates, Inc. CENTRAL INDEX KEY: 0001411574 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-SPECIALTY OUTPATIENT FACILITIES, NEC [8093] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 520 LAKE COOK ROAD STREET 2: SUITE 250 CITY: DEERFIELD STATE: IL ZIP: 60015 BUSINESS PHONE: 847-236-0921 MAIL ADDRESS: STREET 1: 520 LAKE COOK ROAD STREET 2: SUITE 250 CITY: DEERFIELD STATE: IL ZIP: 60015 FORMER COMPANY: FORMER CONFORMED NAME: ASC Acquisition LLC DATE OF NAME CHANGE: 20070905 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Hessler Frederick A. CENTRAL INDEX KEY: 0001587887 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36154 FILM NUMBER: 131180460 MAIL ADDRESS: STREET 1: C/O SURGICAL CARE AFFILIATES, INC. STREET 2: 520 LAKE COOK ROAD, SUITE 250 CITY: DEERFIELD STATE: IL ZIP: 60015 3 1 hessler.xml OWNERSHIP DOCUMENT X0206 3 2013-10-30 0 0001411574 Surgical Care Affiliates, Inc. SCAI 0001587887 Hessler Frederick A. C/O SURGICAL CARE AFFILIATES, INC. 520 LAKE COOK ROAD, SUITE 250 DEERFIELD IL 60015 1 0 0 0 Restricted Equity Units 1324 D The Restricted Equity Units are subject to time-based vesting in equal annual installments over a period of two years from October 1, 2013. Each Restricted Equity Unit is settled on the earlier of the individual's termination of employment or change in control and may be settled in cash at the election of the Issuer's board of directors. /s/ Frederick A. Hessler 2013-10-30