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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
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 control number. | SEC 1474 (9-02) |
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 Underlying Securities (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 of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Stock Option (1) | $ 5.6 | 02/23/2006 | A | 50,000 | (1) | (1) | Common Stock | 50,000 | $ 0 | 50,000 | D | ||||
Stock Option (2) | $ 1.94 | 03/30/2007 | A | 100,000 | (2) | (2) | Common Stock | 100,000 | $ 0 | 100,000 | D | ||||
Stock Option (3) | $ 1.94 | 04/16/2007 | D | 100,000 | (3) | (3) | Common Stock | 100,000 | (3) | 0 | D | ||||
Stock Option (4) | $ 1.86 | 04/16/2007 | A | 250,000 | (4) | (4) | Common Stock | 250,000 | (4) | 250,000 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Berger Edward B 6060 N. DESERT SUN CT TUCSON, AZ 85752 |
X |
Edward Berger | 06/11/2007 | |
**Signature of Reporting Person | Date |
* | 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). |
(1) | The options were awarded on February 23, 2006 as a grant of options under the American CareSource Holdings, Inc. 2005 Stock Option Plan and vest 1/36th per month over a period of three years. Such options have an expiration date of February 23, 2016. |
(2) | The options were awarded on March 30, 2007 as a grant of options under the American CareSource Holdings, Inc. 2005 Stock Option Plan and were subject to vesting 1/12th per month over a one-year period. Such options had an expiration date of March 30, 2017. |
(3) | The options were awarded on March 30, 2007 and were subject to vesting 1/12th per month over a one-year period, and had an expiration date of March 30, 2017. On April 16, 2007, the options were cancelled by the mutual agreement of Mr. Berger and the issuer, and in exchange, Mr. Berger received a new option award on April 16, 2007. |
(4) | On April 16, 2007, the issuer cancelled the stock options awarded to Mr. Berger on March 30, 2007 in exchange for the stock option award reported herein, which is part of Mr. Berger's compensation for assuming expanded, executive responsibilities as the issuer's interim Executive Chairman as of May 2007. The options were awarded on April 16, 2007 as a grant of options under the American CareSource Holdings, Inc. 2005 Stock Option Plan and vest 1/12th per month over a one-year period. Such options have an expiration date of April 16, 2017. |