1
|
NAME OF REPORTING PERSONS
Michael D. Hays
|
||||
2
|
CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (SEE INSTRUCTIONS)
Not Applicable
|
(a) ¨
(b) o
|
|||
3
|
SEC USE ONLY
|
||||
4
|
CITIZENSHIP OR PLACE OF ORGANIZATION
United States
|
||||
NUMBER OF
SHARES
BENEFICIALLY
OWNED BY
EACH
REPORTING
PERSON
WITH
|
5
|
SOLE VOTING POWER
4,696,776
|
|||
6
|
SHARED VOTING POWER
325
|
||||
7
|
SOLE DISPOSITIVE POWER
4,696,776
|
||||
8
|
SHARED DISPOSITIVE POWER
325
|
||||
9
|
AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
4,697,101
|
||||
10
|
CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES (SEE INSTRUCTIONS)
Not Applicable
|
o
|
|||
11
|
PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9)
69.6% (1)
|
||||
12
|
TYPE OF REPORTING PERSON (SEE INSTRUCTIONS)
IN
|
|
(1)
|
This percentage is calculated based on 6,723,790 shares outstanding, as publicly reported by the issuer.
|
Item 1(a).
|
Name of Issuer:
|
|
National Research Corporation
|
Item 1(b).
|
Address of Issuer’s Principal Executive Offices:
|
|
1245 “Q” Street, Lincoln, Nebraska 68508
|
Item 2(a).
|
Name of Person Filing:
|
|
Michael D. Hays
|
Item 2(b).
|
Address of Principal Business Office or, if none, Residence:
|
|
1245 “Q” Street, Lincoln, Nebraska 68508
|
Item 2(c).
|
Citizenship:
|
|
United States
|
Item 2(d).
|
Title of Class of Securities:
|
|
Common Stock, $.001 par value
|
Item 2(e).
|
CUSIP Number:
|
|
637372103
|
Item 3.
|
If this statement is filed pursuant to sections 240.13d-1(b), or 240.13d-2(b) or (c), check whether the person filing is a:
Not applicable.
|
Item 4.
|
Ownership:
|
|
(a)
|
Amount Beneficially Owned (as of December 1, 2010): 4,697,101*
|
|
(b)
|
Percent of Class: 69.6%
|
|
(c)
|
Number of shares as to which such person has:
|
|
(i)
|
sole power to vote or to direct the vote: 4,696,776
|
|
(ii)
|
shared power to vote or to direct the vote: 325
|
|
(iii)
|
sole power to dispose or to direct the disposition of: 4,696,776
|
|
(iv)
|
shared power to dispose or to direct the disposition of: 325
|
|
_______________________
|
|
* Includes 325 shares held by Mr. Hays’ wife and 29,376 shares which Mr. Hays has the right to acquire upon the exercise of stock options. Mr. Hays disclaims beneficial ownership of the 325 shares held by his wife.
|
Item 5.
|
Ownership of Five Percent or Less of a Class:
Not applicable.
|
Item 6.
|
Ownership of More than Five Percent on Behalf of Another Person:
Not applicable.
|
Item 7.
|
Identification and Classification of the Subsidiary Which Acquired the Security Being Reported on by the Parent Holding Company or Control Person:
Not applicable.
|
Item 8.
|
Identification and Classification of Members of the Group:
Not applicable.
|
Item 9.
|
Notice of Dissolution of Group:
Not applicable.
|
Item 10.
|
Certification:
Not applicable.
|