0001144204-19-000700.txt : 20190104 0001144204-19-000700.hdr.sgml : 20190104 20190104172045 ACCESSION NUMBER: 0001144204-19-000700 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190102 FILED AS OF DATE: 20190104 DATE AS OF CHANGE: 20190104 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: 19511144 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 tv510436_4.xml OWNERSHIP DOCUMENT X0306 4 2019-01-02 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 2019-01-02 4 A 0 8164 0 A 66072 D These restricted stock units vest over a series of four (4) successive quarters from issuance but settlement has been deferred until after termination of the reporting person's service. /s/ Craig Tagawa on behalf of David A. Larson 2019-01-04