0001144204-18-034679.txt : 20180618 0001144204-18-034679.hdr.sgml : 20180618 20180618201726 ACCESSION NUMBER: 0001144204-18-034679 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20180614 FILED AS OF DATE: 20180618 DATE AS OF CHANGE: 20180618 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: 18906011 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 tv496635_4.xml OWNERSHIP DOCUMENT X0306 4 2018-06-14 0 0000744825 AMERICAN SHARED HOSPITAL SERVICES AMS 0001610616 Larson David 80 CERRITOS AVE. SAN FRANCISCO CA 94111 1 0 0 0 Common Stock, No Par Value 2018-06-14 4 A 0 500 0 A 57908 D Stock Options (right to buy) 2.68 2018-06-14 4 A 0 2000 0 A 2019-06-13 2025-06-13 Common Stock 2000 2000 D This represents an award of restricted stock units. Each unit will entitle the reporting person to one share of the issuer's common stock upon vesting. The units will vest in full upon the earlier of (I) the reporting person's completion of one year of service measured from June 14, 2018, or (II) such individual's continuation in Board service through the day immediately preceding the 2019 Annual Shareholders Meeting (the "Vesting Date"). Includes 500 shares subject to the reported restricted stock unit award which will vest in full on the Vesting Date. The reported stock option will vest in full upon the earlier of (I) the reporting person's completion of one year of service measured from June 14, 2018, or (II) such individual's continuation in Board service through the day immediately preceding the 2019 Annual Shareholders Meeting (the "Vesting Date"). /s/ Craig Tagawa on behalf of David Larson 2018-06-18