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
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1. Name and Address of Reporting Person*
Tenwick David A

(Last) (First) (Middle)
8503 MISTY WOODS CIRCLE

(Street)
POWELL OH 43065

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
11/10/2006
3. Issuer Name and Ticker or Trading Symbol
ADCARE HEALTH SYSTEMS INC [ ADK ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director X 10% Owner
X Officer (give title below) Other (specify below)
Chairman
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
Form filed by One Reporting Person
X 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 231,916 D
Common Stock 117,920 D
Common Stock 111,157 D
Common Stock 4,400 D
Common Stock 3,800 D
Common Stock 10,125 D
Common Stock 19,120 D
Common Stock 1,200 D
Common Stock 5,000 D
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
1. Name and Address of Reporting Person*
Tenwick David A

(Last) (First) (Middle)
8503 MISTY WOODS CIRCLE

(Street)
POWELL OH 43065

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
X Director X 10% Owner
X Officer (give title below) Other (specify below)
Chairman
1. Name and Address of Reporting Person*
Wade Gary L

(Last) (First) (Middle)
4714 MERRIMONT AVE

(Street)
SPRINGFIELD OH 45503

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
X Director 10% Owner
X Officer (give title below) Other (specify below)
President-CEO
1. Name and Address of Reporting Person*
Williams J Michael

(Last) (First) (Middle)
1844 N FOUNTAIN BLVD

(Street)
SPRINGFIELD OH 45504

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
X Director 10% Owner
X Officer (give title below) Other (specify below)
Exec VP-COO
1. Name and Address of Reporting Person*
Cunningham Jeffrey Scott

(Last) (First) (Middle)
120 DEETER DRIVE

(Street)
CLAYTON OH 45315

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director 10% Owner
X Officer (give title below) Other (specify below)
Vice President-CFO
1. Name and Address of Reporting Person*
Reynolds Sharon L

(Last) (First) (Middle)
7360 BRAUN ROAD

(Street)
GROVEPORT OH 43215

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director 10% Owner
X Officer (give title below) Other (specify below)
Sr Vice President
1. Name and Address of Reporting Person*
Radcliffe Philip S

(Last) (First) (Middle)
106 BURNHAM

(Street)
WILLIAMSBURG OH 23188

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
X Director 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
Sturtz Laurence E

(Last) (First) (Middle)
3421 POINTE CREEK COURT
APT# 106

(Street)
BONITA SPRINGS FL 34134

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
X Director 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
Peterson Clarence A

(Last) (First) (Middle)
150 E WILSON BRIDGE RD
SUITE 230

(Street)
WORTHINGTON OH 43085

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
X Director 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
LEVINE JEFFREY L

(Last) (First) (Middle)
2615 DUNHOLLOW DRIVE

(Street)
SPRINGFIELD OH 45503

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
X Director 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
HACKETT PETER J

(Last) (First) (Middle)
505 WEST HOME RD

(Street)
SPRINGFIELD OH 45504

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
X Director 10% Owner
Officer (give title below) Other (specify below)
Explanation of Responses:
Carol Groeber 12/21/2006
Carol Groeber 12/21/2006
Carol Groeber 12/21/2006
Carol Groeber 12/21/2006
Carol Groeber 12/21/2006
Carol Groeber 12/21/2006
Carol Groeber 12/21/2006
Carol Groeber 12/21/2006
Carol Groeber 12/21/2006
Carol Groeber 12/21/2006
** 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.