0000744825-21-000062.txt : 20210608 0000744825-21-000062.hdr.sgml : 20210608 20210608142840 ACCESSION NUMBER: 0000744825-21-000062 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210604 FILED AS OF DATE: 20210608 DATE AS OF CHANGE: 20210608 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Larson David CENTRAL INDEX KEY: 0001610616 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-08789 FILM NUMBER: 211001900 MAIL ADDRESS: STREET 1: 80 CERRITOS AVE CITY: SAN FRANCISCO STATE: CA ZIP: 94127 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: AMERICAN SHARED HOSPITAL SERVICES CENTRAL INDEX KEY: 0000744825 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MEDICAL LABORATORIES [8071] IRS NUMBER: 942918118 STATE OF INCORPORATION: CA FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 2 EMBARCADERO CENTER STREET 2: SUITE 410 CITY: SAN FRANCISCO STATE: CA ZIP: 94111 BUSINESS PHONE: 415-788-5300 MAIL ADDRESS: STREET 1: 2 EMBARCADERO CENTER STREET 2: SUITE 410 CITY: SAN FRANCISCO STATE: CA ZIP: 94111 4 1 wf-form4_162317690590696.xml FORM 4 X0306 4 2021-06-04 0 0000744825 AMERICAN SHARED HOSPITAL SERVICES AMS 0001610616 Larson David 2 EMBARCADERO CENTER, SUITE 410 SAN FRANCISCO CA 94111 1 0 0 0 Common stock 2021-06-04 4 M 0 2000 3.03 A 88437 D Common stock 2021-06-04 4 F 0 1936 3.13 D 86501 D Common stock 2021-06-04 4 M 0 2000 2.68 A 88501 D Common stock 2021-06-04 4 F 0 1712 3.13 D 86789 D Common stock 2021-06-04 4 M 0 2000 2.25 A 88789 D Common stock 2021-06-04 4 F 0 1438 3.13 D 87351 D Common stock 2021-06-04 4 M 0 2000 2.70 A 89351 D Common stock 2021-06-04 4 F 0 1725 3.13 D 87626 D Common stock 2021-06-04 4 M 0 7500 2.82 A 95126 D Common stock 2021-06-04 4 F 0 6757 3.13 D 88369 D Common stock 2021-06-04 4 M 0 2000 2.43 A 90369 D Common stock 2021-06-04 4 F 0 1553 3.13 D 88816 D Common stock 2021-06-04 4 M 0 7500 2.82 A 93108 D Stock Options (right to buy) 3.03 2021-06-04 4 M 0 2000 3.03 D 2020-06-20 2026-06-20 Common stock 2000.0 0 D Stock Options (right to buy) 2.68 2021-06-04 4 M 0 2000 2.68 D 2019-06-13 2025-06-13 Common stock 2000.0 0 D Stock Options (right to buy) 2.25 2021-06-04 4 M 0 2000 2.25 D 2017-06-20 2023-06-20 Common stock 2000.0 0 D Stock Options (right to buy) 2.7 2021-06-04 4 M 0 2000 2.70 D 2016-06-16 2022-06-15 Common stock 2000.0 0 D Stock Options (right to purchase) 2.82 2021-06-04 4 M 0 7500 2.82 D 2019-12-28 2021-12-29 Common stock 7500.0 0 D STOCK OPTION (RIGHT TO BUY) 2.43 2021-06-04 4 M 0 2000 2.43 D 2015-06-09 2021-06-09 Common stock 2000.0 0 D /s/ Craig K. Tagawa on behalf of David A. Larson 2021-06-07