0001437749-21-015957.txt : 20210629
0001437749-21-015957.hdr.sgml : 20210629
20210629172125
ACCESSION NUMBER: 0001437749-21-015957
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210625
FILED AS OF DATE: 20210629
DATE AS OF CHANGE: 20210629
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: 211059219
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
rdgdoc.xml
FORM 4
X0306
4
2021-06-25
0000744825
AMERICAN SHARED HOSPITAL SERVICES
AMS
0001610616
Larson David
2 EMBARCADERO CENTER, SUITE 410
SAN FRANCISCO
CA
94111
1
Common Stock, No Par Value
2021-06-25
4
A
0
1000
0
A
89816
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 25, 2021, OR SUCH INDIVIDUAL'S CONTINUATION IN BOARD SERVICE THROUGH THE DAY IMMEDIATELY PRECEDING THE 2022 ANNUAL SHAREHOLDERS MEETING (THE "VESTING DATE").
/s/ Craig Tagawa on behalf of David A. Larson
2021-06-29