X0203 3 2010-10-27 0 0001498021 ExamWorks Group, Inc. EXAM 0001414853 Fernandez de Castro Jose Miguel 3280 PEACHTREE ROAD, N.E., SUITE 2625 ATLANTA GA 30305 0 1 0 0 SVP & Chief Financial Officer Common Stock 50691 D Common Stock 84100 I by ExamWorks Holdings, LLLP Series A Convertible Preferred Stock Common Stock 3624 D Employee Stock Option (right to buy) 2.80 2019-04-03 Common Stock 200461 D Employee Stock Option (right to buy) 4.86 2020-02-15 Common Stock 5182 D Employee Stock Option (right to buy) 11.67 2020-10-06 Common Stock 102822 D The reporting person is one of the limited partners of ExamWorks Holdings, LLLP. ExamWorks Holdings, LLLP currently owns 6,728,018 shares of common stock. If ExamWorks Holdings, LLLP distributed such shares of common stock to its limited partners, the reporting person would own 84,100 shares. As a limited partner, the reporting person has no right to participate in the decisions concerning the voting, disposition or conversion of any such securities, and he accordingly disclaims beneficial ownership of the securities held by ExamWorks Holdings, LLLP. Each share of Series A Convertible Preferred Stock will automatically convert into one share of common stock simultaneously upon the completion of the Issuer's initial public offering and has no expiration date. Options to purchase 66,818 shares of common stock are currently vested and options to purchase 133,643 shares of common stock will vest and become exercisable upon the consummation of the Registrant's initial public offering. The shares subject to the option vest in three equal annual installments beginning on February 15, 2011. The shares subject to the option vest in three equal annual installments beginning on October 1, 2011. /s/ J. Miguel Fernandez de Castro 2010-10-27