0001640173-21-000002.txt : 20211001 0001640173-21-000002.hdr.sgml : 20211001 20211001205609 ACCESSION NUMBER: 0001640173-21-000002 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211001 FILED AS OF DATE: 20211001 DATE AS OF CHANGE: 20211001 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Sanders J. Grayson CENTRAL INDEX KEY: 0001640173 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-55434 FILM NUMBER: 211300720 MAIL ADDRESS: STREET 1: 27 LA QUINTA CITY: IRVINE STATE: CA ZIP: 92612 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Griffin-American Healthcare REIT III, Inc. CENTRAL INDEX KEY: 0001566912 STANDARD INDUSTRIAL CLASSIFICATION: REAL ESTATE INVESTMENT TRUSTS [6798] IRS NUMBER: 461749436 STATE OF INCORPORATION: MD FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 18191 VON KARMAN AVENUE STREET 2: SUITE 300 CITY: IRVINE STATE: CA ZIP: 92612 BUSINESS PHONE: 949-270-9200 MAIL ADDRESS: STREET 1: 18191 VON KARMAN AVENUE STREET 2: SUITE 300 CITY: IRVINE STATE: CA ZIP: 92612 4 1 wf-form4_163313614966362.xml FORM 4 X0306 4 2021-10-01 1 0001566912 Griffin-American Healthcare REIT III, Inc. NONE 0001640173 Sanders J. Grayson C/O GRIFFIN-AMERICAN HEALTHCARE REIT III, INC. 18191 VON KARMAN AVE, STE. 300 IRVINE CA 92612 1 0 0 0 Common Stock 2021-10-01 4 D 0 18342 D 0 D Common Stock 2021-10-01 4 D 0 27000 D 0 I By Sanders Living Trust DTD 1/25/2017 Reflects the disposition of shares of the Issuer's common stock in connection with the merger (the "Merger") of the Issuer with and into Continental Merger Sub, LLC, a wholly-owned subsidiary of American Healthcare REIT, Inc. ("AHR"). In the Merger, each share of the Issuer's common stock, par value $0.01 per share, was converted into the right to receive 0.9266 shares of AHR Class I common stock, par value $0.01 per share ("AHR Class I Common Stock"). There is no established market for shares of AHR Class I Common Stock. On March 18, 2021, the board of directors of AHR approved an estimated value per share of AHR Class I Common Stock of $9.22. The reported shares of common stock are held directly by Sanders Living Trust, DTD 1/25/2017, and indirectly by J. Grayson Sanders and Marylee Sanders, Trustees. /s/ J. GRAYSON SANDERS 2021-10-01