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