0001437749-22-014095.txt : 20220602
0001437749-22-014095.hdr.sgml : 20220602
20220602143154
ACCESSION NUMBER: 0001437749-22-014095
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20220531
FILED AS OF DATE: 20220602
DATE AS OF CHANGE: 20220602
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Stachowiak Raymond C
CENTRAL INDEX KEY: 0001609580
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-08789
FILM NUMBER: 22990295
MAIL ADDRESS:
STREET 1: C/O ASHS
STREET 2: 2 EMBARCADERO CENTER-SUITE 410
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94111
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: 601 MONTGOMERY STREET
STREET 2: SUITE 1112
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94111
BUSINESS PHONE: 415-788-5300
MAIL ADDRESS:
STREET 1: 601 MONTGOMERY STREET
STREET 2: SUITE 1112
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94111
4
1
rdgdoc.xml
FORM 4
X0306
4
2022-05-31
0000744825
AMERICAN SHARED HOSPITAL SERVICES
AMS
0001609580
Stachowiak Raymond C
601 MONTGOMERY STREET
SAN FRANCISCO
CA
94111
1
1
1
CEO
Common Stock, No Par Value
2022-05-31
4
M
0
2000
2.70
A
416178
D
Common Stock, No Par Value
57000
I
By RCS Investments Inc.
Common Stock, No Par Value
760559
I
By Stachowiack
Equity Fund LLC
Stock Options (right to buy)
2.70
2022-05-31
4
M
0
2000
0
D
2016-06-15
2022-06-15
Common Stock
2000
0
D
/s/ Craig K. Tagawa on behalf of Raymond C. Stachowiak.
2022-06-02