0001609580-14-000001.txt : 20140624 0001609580-14-000001.hdr.sgml : 20140624 20140613154757 ACCESSION NUMBER: 0001609580-14-000001 CONFORMED SUBMISSION TYPE: 4/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20140102 FILED AS OF DATE: 20140613 DATE AS OF CHANGE: 20140613 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: FOUR EMBARCADERO CENTER STREET 2: SUITE 3700 CITY: SAN FRANCISCO STATE: CA ZIP: 94111-4107 BUSINESS PHONE: 415-788-5300 MAIL ADDRESS: STREET 1: FOUR EMBARCADERO CENTER STREET 2: SUITE 3700 CITY: SAN FRANCISCO STATE: CA ZIP: 94111-4107 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Stachowiak Raymond C CENTRAL INDEX KEY: 0001609580 FILING VALUES: FORM TYPE: 4/A SEC ACT: 1934 Act SEC FILE NUMBER: 001-08789 FILM NUMBER: 14910042 MAIL ADDRESS: STREET 1: C/O ASHS STREET 2: FOUR EMBARCADERO CENTER CITY: SAN FRANCISCO STATE: CA ZIP: 94111-4107 4/A 1 primary_doc.xml PRIMARY DOCUMENT X0306 4/A 2014-01-02 2010-06-03 0 0000744825 AMERICAN SHARED HOSPITAL SERVICES AMS 0001609580 Stachowiak Raymond C C/O ASHS FOUR EMBARCADERO CENTER SAN FRANCISCO CA 94111-4107 1 0 0 0 COMMON STOCK NO PAR VALUE 2014-01-02 4 A 0 7576 0 A 29847 D COMMON STOCK NO PAR VALUE 2014-06-10 4 A 0 500 0 A 30347 D COMMON STOCK NO PAR VALUE 2014-06-12 4 P 0 400000 2.43 A 455000 I BY RCS INVESTMENTS INC OPTION TO ACQUIRE 2.81 2010-06-02 4 A 0 2000 0 A 2010-06-02 2017-06-01 COMMON STOCK NO PAR VALUE 2000 7000 D OPTION TO ACQUIRE 2.43 2014-06-10 4 A 0 2000 0 A 2014-06-10 2021-06-09 COMMON STOCK NO PAR VALUE 2000 15000 D VESTS IN FULL ON THE EARLIER OF THE ONE-YEAR ANNIVERSARY OF THE TRANSACTION DATE OR THE REPORTING PERSON'S CONTINUED SERVICE THROUGH THE DAY BEFORE THE NEXT ANNUAL MEETING. ERIC OHWA ON BEHALF OF RAYMOND C STACHOWIAK 2014-06-13