0000899243-19-005510.txt : 20190301
0000899243-19-005510.hdr.sgml : 20190301
20190301182739
ACCESSION NUMBER: 0000899243-19-005510
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20190301
FILED AS OF DATE: 20190301
DATE AS OF CHANGE: 20190301
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: HENDRICKSON CAREY P
CENTRAL INDEX KEY: 0001482760
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-13445
FILM NUMBER: 19651147
MAIL ADDRESS:
STREET 1: 400 S. RECORD STREET
CITY: DALLAS
STATE: TX
ZIP: 75202
ISSUER:
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
BUSINESS ADDRESS:
STREET 1: 14160 DALLAS PARKWAY
STREET 2: SUITE 300
CITY: DALLAS
STATE: TX
ZIP: 75254
BUSINESS PHONE: 9727705600
MAIL ADDRESS:
STREET 1: 14160 DALLAS PARKWAY
STREET 2: SUITE 300
CITY: DALLAS
STATE: TX
ZIP: 75254
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2019-03-01
0
0001043000
CAPITAL SENIOR LIVING CORP
CSU
0001482760
HENDRICKSON CAREY P
14160 DALLAS PARKWAY
SUITE 300
DALLAS
TX
75254
0
1
0
0
Executive Vice President & CFO
Common Stock
2019-03-01
4
D
0
2280
0.00
D
252105
D
Represents shares of performance-based restricted stock that were previously reported as beneficially owned by the reporting person as of February 24, 2016, but were subsequently forfeited due to the Company achieving 82.5% (but not 100%) of the performance target with respect to such shares for fiscal 2018.
/s/ Carey P. Hendrickson
2019-03-01