0001610616-14-000001.txt : 20140624 0001610616-14-000001.hdr.sgml : 20140624 20140616163809 ACCESSION NUMBER: 0001610616-14-000001 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20140610 FILED AS OF DATE: 20140616 DATE AS OF CHANGE: 20140616 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: Larson David CENTRAL INDEX KEY: 0001610616 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-08789 FILM NUMBER: 14923133 MAIL ADDRESS: STREET 1: 80 CERRITOS AVE CITY: SAN FRANCISCO STATE: CA ZIP: 94127 4 1 primary_doc.xml PRIMARY DOCUMENT X0306 4 2014-06-10 0 0000744825 AMERICAN SHARED HOSPITAL SERVICES AMS 0001610616 Larson David 80 CERRITOS AVE SAN FRANCISCO CA 94127 1 0 0 0 COMMON STOCK 2014-06-10 4 A 0 7576 0 A 35292 D COMMON STOCK 2014-06-10 4 A 0 500 0 A 35792 D STOCK OPTION (RIGHT TO BUY) 2.43 2014-06-10 4 A 0 2000 0 A 2014-06-10 2021-06-09 COMMON STOCK 2000 2000 D THIS REPRESENTS AN AWARD OF RESTRICTED STOCK UNITS AWARDED ANNUALLY TO EACH BOARD OF DIRECTOR IN LIEU OF RECEIPT OF QUARTERLY CASH COMPENSATION. EACH UNIT WILL ENTITLE THE REPORTING PERSON TO ONE SHARE OF THE ISSUER'S COMMON STOCK UPON VESTING. THE AWARD WAS GRANTED ON JANUARY 2, 2014 (THE FIRST BUSINESS DAY OF THE CALENDAR YEAR) AND DIVIDED INTO FOUR SEPARATE AMOUNTS OF COMMON STOCK THAT VEST AT THREE MONTHS, SIX MONTHS, NINE MONTHS AND TWELVE MONTHS, RESPECTIVELY. THE AWARD WAS GRANTED FOR THE CALENDAR YEAR OF 2014 BUT THE COMPANY PREVIOUSLY DID NOT FILE A FORM 4 ON BEHALF OF EACH BOARD OF DIRECTOR FOR THIS 2014 AWARD. INCLUDES 7,576 SHARES SUBJECT TO THE RESTRICTED STOCK UNIT AWARD WHICH WILL VEST IN FULL ON THE VESTING DATE. 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 10, 2014, OR SUCH INDIVIDUAL'S CONTINUATION IN BOARD SERVICE THROUGH THE DAY IMMEDIATELY PRECEDING THE 2015 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 10, 2014, OR (II) SUCH INDIVIDUAL'S CONTINUATION IN BOARD SERVICE THROUGH THE DAY IMMEDIATELY PRECEDING THE 2015 ANNUAL SHAREHOLDERS MEETING (THE "VESTING DATE"). ERIC OHWA ON BEHALF OF DAVID A LARSON, MD 2014-06-16