FORM 4 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). |
1. Name and Address of Reporting Person*
(Street)
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2. Issuer Name and Ticker or Trading Symbol
SUNLINK HEALTH SYSTEMS INC [ SSY ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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3. Date of Earliest Transaction
(Month/Day/Year) 11/14/2011 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed
(Month/Day/Year) |
6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | ||||||||||
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1. Title of Security (Instr. 3) | 2. Transaction Date (Month/Day/Year) | 2A. Deemed Execution Date, if any (Month/Day/Year) | 3. Transaction Code (Instr. 8) | 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) | 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) | 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 7. Nature of Indirect Beneficial Ownership (Instr. 4) | |||
Code | V | Amount | (A) or (D) | Price | ||||||
Common Stock | 11/14/2011 | S | 1,600 | D | (1) | 163,185(2) | I | As sole member and manager of Fortuna Asset Management, LLC | ||
Common Stock | 04/02/2013 | S | 50,000 | D | (1) | 113,185(2) | I | As sole member and manager of Fortuna Asset Management, LLC | ||
Common Stock | 04/02/2013 | S | 50,000 | D | (1) | 63,185(2) | I | As sole member and manager of Fortuna Asset Management, LLC | ||
Common Stock | 01/27/2014 | S | 5,420 | D | (3) | 57,765(2) | I | As sole member and manager of Fortuna Asset Management, LLC | ||
Common Stock | 05/19/2014 | S | 5,200 | D | (1) | 52,565(2) | I | As sole member and manager of Fortuna Asset Management, LLC | ||
Common Stock(4) | 07/28/2011(4) | P(4) | 0(4) | A | (4) | 59,469 | I | As Trustee of Fortuna Asset Management Defined Benefit Plan | ||
Common Stock(4) | 03/02/2011(4) | P(4) | 0(4) | A | (4) | 21,761(5) | I | By Spouse(5) | ||
Common Stock(4) | 03/02/2011(4) | P(4) | 0(4) | A | (4) | 5,000 | I | As General Partner of Courtland Investments | ||
Common Stock(6) | 03/02/2011(6) | P(6) | 0(6) | A | (6) | 7,500 | D |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||||||||||
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1. Title of Derivative Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) | 6. Date Exercisable and Expiration Date (Month/Day/Year) | 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) | 8. Price of Derivative Security (Instr. 5) | 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) | 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) | ||||
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Explanation of Responses: |
1. This represents shares held in a client managed account that is no longer managed by Fortuna Asset Management, LLC. |
2. This number includes shares that are held in client managed accounts, and the Reporting Person has only a limited power of attorney to buy or sell shares, but no power to vote such shares. |
3. This transaction represents shares sold for a client in a non-performance-based fee account at the direction of and for the benefit of such client. |
4. This row reflects indirect ownership which has not changed as a result of the transactions reported on this form. |
5. Consists of 5,888 shares owned by Spouse's IRA and 15,873 shares owned by Ashwood Trust. Spouse is the Trustee and sole beneficiary of Ashwood Trust. |
6. This row reflects direct ownership which has not changed as a result of the transactions reported on this form. |
M. Timothy Elder, pursuant to a power of attorney | 06/30/2015 | |
** Signature of Reporting Person | Date | |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | ||
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v). | ||
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). | ||
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |