0001104659-18-048422.txt : 20180731
0001104659-18-048422.hdr.sgml : 20180731
20180731164107
ACCESSION NUMBER: 0001104659-18-048422
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20180730
FILED AS OF DATE: 20180731
DATE AS OF CHANGE: 20180731
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: MARTIN GERARD M.
CENTRAL INDEX KEY: 0001241557
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-16817
FILM NUMBER: 18981644
MAIL ADDRESS:
STREET 1: C/O THE RMR GROUP LLC
STREET 2: TWO NEWTON PL., 255 WASH. ST., STE. 300
CITY: NEWTON
STATE: MA
ZIP: 02458
FORMER NAME:
FORMER CONFORMED NAME: MARTIN GERARD M
DATE OF NAME CHANGE: 20030613
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: FIVE STAR SENIOR LIVING INC.
CENTRAL INDEX KEY: 0001159281
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-SKILLED NURSING CARE FACILITIES [8051]
IRS NUMBER: 043516029
STATE OF INCORPORATION: MD
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 400 CENTRE STREET
CITY: NEWTON
STATE: MA
ZIP: 02458
BUSINESS PHONE: (617) 796 8387
MAIL ADDRESS:
STREET 1: 400 CENTRE STREET
CITY: NEWTON
STATE: MA
ZIP: 02458
FORMER COMPANY:
FORMER CONFORMED NAME: FIVE STAR QUALITY CARE, INC.
DATE OF NAME CHANGE: 20161006
FORMER COMPANY:
FORMER CONFORMED NAME: FIVE STAR QUALITY CARE INC
DATE OF NAME CHANGE: 20010918
4
1
a4.xml
4
X0306
4
2018-07-30
0
0001159281
FIVE STAR SENIOR LIVING INC.
NASDAQ:FVE
0001241557
MARTIN GERARD M.
C/O THE RMR GROUP LLC
TWO NEWTON PL., 255 WASH. ST., STE. 300
NEWTON
MA
02458
1
0
0
0
Common Stock
2018-07-30
5
G
0
E
12371.9
0
D
0
I
See footnote
Common Stock
2018-07-30
5
G
0
E
123.719
0
A
123.719
I
See footnote
Common Stock
244250
D
The reported securities were formerly held by The Rye, Inc. On July 30, 2018, The Rye, Inc. distributed the shares of common stock of the Issuer it held to its shareholders, including 123.719 shares of common stock to The Kathleen R. Martin Non-Exempt QTIP Trust-2007, of which Mr. Martin is a trustee and beneficiary. Following these distributions, Mr. Martin may be deemed to continue to indirectly beneficially own the shares of common stock of the Issuer distributed to The Kathleen R. Martin Non-Exempt QTIP Trust-2007, but Mr. Martin disclaims such beneficial ownership except to the extent of his pecuniary interest therein.
/s/ Gerard M. Martin
2018-07-30