SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
OMB APPROVAL
OMB Number: 3235-0104
Estimated average burden
hours per response: 0.5
1. Name and Address of Reporting Person*
Brogdon Christopher F

(Last) (First) (Middle)
593 ATLANTA STREET

(Street)
ROSWELL GA 30075

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
05/08/2008
3. Issuer Name and Ticker or Trading Symbol
ADCARE HEALTH SYSTEMS INC [ ADK ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director X 10% Owner
Officer (give title below) Other (specify below)
5. If Amendment, Date of Original Filed (Month/Day/Year)
05/08/2008
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock 47,665(1) D
Common Stock 107,180(2) I By spouse
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Warrant (3) 11/10/2011 Common Stock 107,000(4) $5.4 I By spouse as UGMA custodian for daughter
Explanation of Responses:
1. Nine hundred (900) shares of common stock were inadvertently omitted from the reporting person's original Form 3. In addition, three hundred fifty eight (358) shares of common stock were incorrectly reported on his original Form 3 as directly owned by the reporting person instead of indirectly owned.
2. Three hundred fifty eight (358) shares of common stock indirectly owned by the reporting person were inadvertently omitted from the reporting person's original Form 3.
3. The Warrants are currently exercisable.
4. Four thousand (4,000) Warrants indirectly owned by the reported person were inadvertently omitted from his original Form 3.
Remarks:
/s/ Christopher F. Brogdon 11/21/2008
** 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 5 (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.