0001104659-21-078546.txt : 20210609
0001104659-21-078546.hdr.sgml : 20210609
20210609083828
ACCESSION NUMBER: 0001104659-21-078546
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210608
FILED AS OF DATE: 20210609
DATE AS OF CHANGE: 20210609
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Wagner Michael E.
CENTRAL INDEX KEY: 0001803911
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-16817
FILM NUMBER: 211004058
MAIL ADDRESS:
STREET 1: C/O FIVE STAR SENIOR LIVING INC.
STREET 2: 400 CENTRE STREET
CITY: NEWTON
STATE: MA
ZIP: 02458
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
tm2119007d3_4.xml
OWNERSHIP DOCUMENT
X0306
4
2021-06-08
0
0001159281
FIVE STAR SENIOR LIVING INC.
NASDAQ:FVE
0001803911
Wagner Michael E.
C/O FIVE STAR SENIOR LIVING INC.,
400 CENTRE STREET
NEWTON
MA
02458
1
0
0
0
Common Stock
2021-06-08
4
A
0
12500
0
A
19500
D
Transaction reported is grant of shares pursuant to issuer's equity compensation plan.
/s/ Michael E. Wagner
2021-06-08