0001104659-19-034840.txt : 20190611
0001104659-19-034840.hdr.sgml : 20190611
20190611184645
ACCESSION NUMBER: 0001104659-19-034840
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20190611
FILED AS OF DATE: 20190611
DATE AS OF CHANGE: 20190611
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: PORTNOY ADAM D.
CENTRAL INDEX KEY: 0001273871
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-16817
FILM NUMBER: 19892124
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: PORTNOY ADAM D
DATE OF NAME CHANGE: 20160607
FORMER NAME:
FORMER CONFORMED NAME: PORTNOY ADAM
DATE OF NAME CHANGE: 20031218
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
2019-06-11
0
0001159281
FIVE STAR SENIOR LIVING INC.
NASDAQ:FVE
0001273871
PORTNOY ADAM D.
C/O THE RMR GROUP LLC
TWO NEWTON PL., 255 WASH. ST., STE. 300
NEWTON
MA
02458
1
0
1
0
Common Stock
2019-06-11
4
A
0
12500
A
175500
D
Common Stock
17999999
I
See Footnote
Transaction reported is grant of shares pursuant to the issuer's equity compensation plan.
These shares are held by ABP Acquisition LLC. ABP Acquisition LLC is a wholly owned subsidiary of ABP Trust; Mr. Portnoy, as president, sole trustee and a beneficial owner of ABP Trust, may be deemed to be a beneficial owner of these shares, but Mr. Portnoy disclaims such beneficial ownership except to the extent of his pecuniary interest therein.
/s/ Adam D. Portnoy
2019-06-11