0001610616-16-000004.txt : 20160106
0001610616-16-000004.hdr.sgml : 20160106
20160106141604
ACCESSION NUMBER: 0001610616-16-000004
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20160104
FILED AS OF DATE: 20160106
DATE AS OF CHANGE: 20160106
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: 161326344
MAIL ADDRESS:
STREET 1: 80 CERRITOS AVE
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94127
4
1
primary_doc.xml
PRIMARY DOCUMENT
X0306
4
2016-01-04
0
0000744825
AMERICAN SHARED HOSPITAL SERVICES
AMS
0001610616
Larson David
80 CERRITOS AVE
SAN FRANCISCO
CA
94127
1
0
0
0
Common Stock
2016-01-04
4
A
0
10582
0
A
46874
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/ Chloe Tagawa on behalf of David Larson
2016-01-06