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