0001144204-17-023180.txt : 20170428 0001144204-17-023180.hdr.sgml : 20170428 20170428155450 ACCESSION NUMBER: 0001144204-17-023180 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170403 FILED AS OF DATE: 20170428 DATE AS OF CHANGE: 20170428 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Summit Healthcare REIT, Inc CENTRAL INDEX KEY: 0001310383 STANDARD INDUSTRIAL CLASSIFICATION: REAL ESTATE INVESTMENT TRUSTS [6798] IRS NUMBER: 731721791 STATE OF INCORPORATION: MD FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 2 SOUTH POINTE DRIVE STREET 2: STE 100 CITY: LAKE FOREST STATE: CA ZIP: 92630 BUSINESS PHONE: 949-535-2022 MAIL ADDRESS: STREET 1: 2 SOUTH POINTE DRIVE STREET 2: STE 100 CITY: LAKE FOREST STATE: CA ZIP: 92630 FORMER COMPANY: FORMER CONFORMED NAME: Cornerstone Core Properties REIT, Inc. DATE OF NAME CHANGE: 20050518 FORMER COMPANY: FORMER CONFORMED NAME: Cornerstone Core Properties REIT DATE OF NAME CHANGE: 20050516 FORMER COMPANY: FORMER CONFORMED NAME: Cornerstone Realty Fund Inc DATE OF NAME CHANGE: 20041202 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: PAGLIARINI ELIZABETH A. CENTRAL INDEX KEY: 0001618431 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-52566 FILM NUMBER: 17795225 MAIL ADDRESS: STREET 1: 2 SOUTH POINTE DR. STREET 2: SUITE 100 CITY: LAKE FOREST STATE: CA ZIP: 92630 4 1 v465612_4.xml OWNERSHIP DOCUMENT X0306 4 2017-04-03 0 0001310383 Summit Healthcare REIT, Inc NONE 0001618431 PAGLIARINI ELIZABETH A. 2 SOUTH POINTE DR., SUITE 100 LAKE FOREST CA 92630 0 1 0 0 Chief Financial Officer Incentive Stock Option (Right to Buy) 2.04 2017-04-03 4 A 0 70000 0.00 A 2027-04-02 Common Stock 70000 70000 D The options were granted pursuant to the Summit Healthcare REIT, Inc. 2015 Omnibus Incentive Plan. The options are exercisable as follows: (a) 23,333 commencing on April 3, 2017 (b) and the remaining 46,667 in 24 equal monthly installments commencing on May 1, 2017. /s/ Elizabeth Pagliarini 2017-04-28