-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, DbRUWQQTJ+c8WqqzYJEOAC2Ks7gsy/QNjy0S/IM+tJQkCPSX53WWXsGv57wKKeQ9 s2gzDS7b2MHfXQBYMmdcSA== 0000899078-05-000116.txt : 20050214 0000899078-05-000116.hdr.sgml : 20050214 20050214142150 ACCESSION NUMBER: 0000899078-05-000116 CONFORMED SUBMISSION TYPE: 8-K PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20050210 ITEM INFORMATION: Other Events ITEM INFORMATION: Financial Statements and Exhibits FILED AS OF DATE: 20050214 DATE AS OF CHANGE: 20050214 FILER: COMPANY DATA: COMPANY CONFORMED NAME: CAPITAL SENIOR LIVING CORP CENTRAL INDEX KEY: 0001043000 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-NURSING & PERSONAL CARE FACILITIES [8050] IRS NUMBER: 752678809 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 8-K SEC ACT: 1934 Act SEC FILE NUMBER: 001-13445 FILM NUMBER: 05607557 BUSINESS ADDRESS: STREET 1: 14160 DALLAS PKWY STREET 2: STE 300 CITY: DALLAS STATE: TX ZIP: 75240 BUSINESS PHONE: 9727705600 MAIL ADDRESS: STREET 1: 14160 DALLAS PKWY STREET 2: STE 300 CITY: DALLAS STATE: TX ZIP: 75240 8-K 1 feb2005-form8k.txt FORM 8-K DATED FEBRUARY 10, 2005 UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, DC 20549 FORM 8-K CURRENT REPORT Pursuant to Section 13 or 15(d) of the Securities Exchange Act of 1934 Date of report (Date of earliest event reported) February 10, 2005 ----------------------------- Capital Senior Living Corporation - ------------------------------------------------------------------------------- (Exact Name of Registrant as Specified in Its Charter) Delaware - ------------------------------------------------------------------------------- (State or Other Jurisdiction of Incorporation) 1-13445 75-2678809 - ------------------------------------------------------------------------------- (Commission File Number) (IRS Employer Identification No.) 14160 Dallas Parkway Suite 300 Dallas Texas 75254 - ------------------------------------------------------------------------------- (Address of Principal Executive Offices) (Zip Code) (972) 770-5600 - ------------------------------------------------------------------------------- (Registrant's Telephone Number, Including Area Code) - ------------------------------------------------------------------------------- (Former Name or Former Address, if Changed Since Last Report) Check the appropriate box below if the Form 8-K filing is intended to simultaneously satisfy the filing obligation of the registrant under any of the following provisions (see General Instruction A.2. below): |_| Written communications pursuant to Rule 425 under the Securities Act (17 CFR 230.425) |_| Soliciting material pursuant to Rule 14a-12 under the Exchange Act (17 CFR 240.14a-12) |_| Pre-commencement communications pursuant to Rule 14d-2(b) under the Exchange Act (17 CFR 240.14d-2(b)) |_| Pre-commencement communications pursuant to Rule 13e-4(c) under the Exchange Act (17 CFR 240.13e-4(c)) Item 8.01 Other Events. On February 10, 2005, the Compensation Committee of the Board of Directors of the registrant approved the form of Restricted Stock Award under the 1997 Omnibus Stock and Incentive Plan or Capital Senior Living Corporation. A form of Restricted Stock Award is attached as an exhibit to this Current Report on Form 8-K and is incorporated by reference herein. Item 9.01 Financial Statements and Exhibits (a) Not applicable. (b) Not applicable. (c) Exhibits. 10.1 Form of Restricted Stock Award Under the 1997 Omnibus Stock and Incentive Plan for Capital Senior Living Corporation SIGNATURES Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned hereunto duly authorized. Date: February 14, 2005 Capital Senior Living Corporation By: /s/ David R. Brickman Name: David R. Brickman Title: Vice President and General Counsel EXHIBIT INDEX Exhibit No. Exhibit Name 10.1 Form of Restricted Stock Award Under the 1997 Omnibus Stock and Incentive Plan for Capital Senior Living Corporation EX-10 2 feb2005-exhibit.txt EXHIBIT 10.1, RESTRICTED STOCK AWARD Exhibit 10.1 RESTRICTED STOCK AWARD UNDER THE 1997 OMNIBUS STOCK AND INCENTIVE PLAN for CAPITAL SENIOR LIVING CORPORATION Effective as of ____________ ("Date of Grant"), a RESTRICTED STOCK AWARD ("Award") is granted by Capital Senior Living Corporation (the "Company") to ____________ (the "Holder"), this Award being in all respects subject to the terms, definitions and provisions, of the 1997 Omnibus Stock and Incentive Plan For Capital Senior Living Corporation (the "Plan"), and all of which are incorporated herein by reference, except to the extent otherwise expressly provided in this Award. 1. Restricted Share Award. The Company hereby sells, transfers, assigns and delivers to the Holder an aggregate of ___________ Shares ("Award Restricted Shares") on the terms and conditions set forth in this Award, including, without limitation, the Restriction more specifically set forth in Section 3. below, subject only to (i) Holder's execution of this Award agreement, and (ii) Holders payment to the Company, within 30 days of the Date of Grant, an amount equal to $.01 (the par value) times the number of Award Restricted Shares. 2. Vesting of Award Restricted Shares. The Restriction on the Award Restricted Shares shall lapse (Award Restricted Shares with respect to which the Restriction has lapsed being herein referred to as "Vested Shares") in accordance with the following vesting schedule: (i) 25% of the Award Restricted Shares shown in Section 1, on the 1st anniversary of the Date of Grant. (ii) 25% of the Award Restricted Shares shown in Section 1 on the 2nd anniversary of the Date of Grant. (iii) 25% of the Award Restricted Shares shown in Section 1 on the 3rd anniversary of the Date of Grant. (iv) 25% of the Award Restricted Shares shown in Section 1 on the 4th anniversary of the Date of Grant. so that, without limitation, the Restriction on all of the Award Restricted Shares will have lapsed no later than the fourth anniversary of the Date of Grant. 3. Restriction - Forfeiture of Award Restricted Shares. The Award Restricted Shares are each subject to the restriction ("Restriction") that all rights of Holder to any Award Restricted Shares which have not become Vested Shares shall, automatically and without notice, terminate and be permanently forfeited on the date Holder, for any reason, ceases to be employed by the Company. 4. Withholding. On the date Award Restricted Shares become Vested Shares, the minimum withholding required to be made by the Company shall be paid by Holder to the Committee (as defined in the Plan) in cash, or by delivery of Shares, which Shares may be in whole or in part Vested Shares, based on the fair market value of such Shares on the date of delivery. 5. Issuance of Shares. During the restricted period, the certificates representing the Award Restricted Shares, and any Restricted Share Distributions, shall be registered in the Holder's name and bear a restrictive legend disclosing the Restriction and the existence of this Award. Such certificates shall be deposited by the Holder with the Company, together with stock powers or other instruments of assignment, each endorsed in blank, which will permit the transfer to the Company of all or any portion of the Award Restricted Shares, and any assets constituting Restricted Share Distributions, which shall be forfeited in accordance with the terms of this Award. The Company will retain custody of all related Restricted Share Distributions (i.e., dividends, which will be subject to the same Restriction, terms, and conditions as the related Award Restricted Shares) unless and until Holder is entitled to receive the certificates for the related Vested Shares; provided, however, that any Restricted Share Distributions shall not bear interest or be segregated into a separate account but shall remain a general asset of the Company, subject to the claims of the Company's creditors, until the conclusion of the applicable restricted period; and provided, further, that any material breach of any terms of this Award, as reasonably determined by the Committee, will cause a forfeiture of both Award Restricted Shares and Restricted Share Distributions. Award Restricted Shares shall constitute issued and outstanding Common Stock for all corporate purposes and, without limitation, Holder shall have all of the rights and privileges of an owner of the Award Restricted Shares (including voting rights) except that Holder shall not be entitled to delivery of the certificates evidencing any of the Award Restricted Shares, nor the related Restricted Share Distributions, unless and until they become Vested Shares. 6. Administration of Award. The determinations under, and the interpretations of, any provision of this Award by the Committee shall, in all cases, be in its sole discretion, and shall be final and conclusive. 7. No Transfers Permitted. Without limitation, the rights under this Award are not transferable. 8. Section 83(b) Election. Holder may elect under Section 83(b) of the Code to include in his or her gross income, for his or her taxable year in which the Award Restricted Shares are transferred to such Holder under this Award, the excess of the fair market value (determined without regard to any Restriction other than one which by its terms will never lapse), of such Award Restricted Shares at the Date of Grant, over the amount (if any) paid for the Award Restricted Shares. If the Holder makes the Section 83(b) election described above, the Holder shall (i) make such election in a manner that is satisfactory to the Committee, (ii) provide the Committee with a copy of such election, (iii) agree to promptly notify the Company if any Internal Revenue Service or state tax agent, on audit or otherwise, questions the validity or correctness of such election or of the amount of income reportable on account of such election, and (iv) agree to pay the withholding amounts described in Section 4. above. 9. Interpretation. (a) If any provision of this Award is held invalid for any reason, such holding shall not affect the remaining provisions hereof, but instead the Award shall be construed and enforced as if such provision had never been included in the Award. (b) THIS AWARD SHALL BE GOVERNED BY THE LAWS OF THE STATE OF TEXAS. (c) Headings contained in this Award are for convenience only and shall in no manner be construed as part of this Award. (d) Any reference to the masculine, feminine, or neuter gender shall be a reference to such other gender as is appropriate. Dated as of this ________ day of __________, 2005. CAPITAL SENIOR LIVING CORPORATION By: _______________________________ Assignment Separate From Certificate FOR VALUE RECEIVED, the undersigned hereby sells, assigns and transfers unto Capital Senior Living Corporation the _____ Shares subject to this Award, standing in the undersigned's name on the books of said Capital Senior Living Corporation, represented by Certificate No. _____ herewith and do hereby irrevocably constitute and appoint the corporate secretary of Capital Senior Living Corporation as attorney to transfer the said stock on the books of Capital Senior Living Corporation with full power of substitution in the premises. Dated ____________________ ------------------------------ Holder ACKNOWLEDGMENT The undersigned hereby acknowledges (i) my receipt of this Award and a copy of the Plan, (ii) my opportunity to discuss this Award with a representative of the Company, and my personal advisors, to the extent I deem necessary or appropriate, (iii) my understanding of the terms and provisions of this Award, and (iv) my understanding that, by my signature below, I am agreeing to be bound by all of the terms and provisions of this Award. Without limitation, I agree to accept as binding, conclusive and final all decisions or interpretations of the Committee (as defined in the Plan) upon any questions arising under this Award or the Plan. Dated as of this ________ day of ______________, 2005. ------------------------------ Holder -----END PRIVACY-ENHANCED MESSAGE-----