0001171843-15-002221.txt : 20150427 0001171843-15-002221.hdr.sgml : 20150427 20150427181239 ACCESSION NUMBER: 0001171843-15-002221 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20150424 FILED AS OF DATE: 20150427 DATE AS OF CHANGE: 20150427 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: American CareSource Holdings, Inc. CENTRAL INDEX KEY: 0001316645 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MISC HEALTH & ALLIED SERVICES, NEC [8090] IRS NUMBER: 200428568 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1170 PEACHTREE STREET, NE STREET 2: SUITE 2350 CITY: ATLANTA STATE: GA ZIP: 30309 BUSINESS PHONE: 972-308-6830 MAIL ADDRESS: STREET 1: 1170 PEACHTREE STREET, NE STREET 2: SUITE 2350 CITY: ATLANTA STATE: GA ZIP: 30309 FORMER COMPANY: FORMER CONFORMED NAME: American Caresource Holdings, Inc. DATE OF NAME CHANGE: 20050615 FORMER COMPANY: FORMER CONFORMED NAME: American Caresouce Holdings, Inc. DATE OF NAME CHANGE: 20050204 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: KINLEY MATTHEW P CENTRAL INDEX KEY: 0001335269 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-33094 FILM NUMBER: 15796201 MAIL ADDRESS: STREET 1: 2116 FINANCIAL CENTER CITY: DES MOINES STATE: IA ZIP: 50309 4 1 gff4_kinley042715.xml OWNERSHIP DOCUMENT X0306 4 2015-04-24 0 0001316645 American CareSource Holdings, Inc. ANCI 0001335269 KINLEY MATTHEW P C/O AMERICAN CARESOURCE HOLDINGS, INC. 1170 PEACHTREE STREET NE, SUITE 2350 ATLANTA GA 30309 1 0 0 0 Common Stock 2015-04-24 4 M 0 9372 0.933 A 141384 D Stock option (right to buy) 0.933 2015-04-24 4 M 0 9372 0 D 2015-05-01 Common Stock 9372 0 D The option became exercisable in 36 monthly installments beginning on May 1, 2005, which was the date on which the option was granted. /s/ Matthew P. Kinley 2015-04-27