0001171843-15-003063.txt : 20150522 0001171843-15-003063.hdr.sgml : 20150522 20150522165734 ACCESSION NUMBER: 0001171843-15-003063 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20150520 FILED AS OF DATE: 20150522 DATE AS OF CHANGE: 20150522 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: Winland Norman Benny CENTRAL INDEX KEY: 0001643204 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-33094 FILM NUMBER: 15887300 MAIL ADDRESS: STREET 1: 4404 RISINGHILL DRIVE CITY: PLANO STATE: TX ZIP: 75024 4 1 formfour.xml X0306 4 2015-05-20 0 0001316645 American CareSource Holdings, Inc. ANCI 0001643204 Winland Norman Benny 1170 PEACHTREE STREET NE, SUITE 2350 ATLANTA GA 30309 0 1 0 0 President and COO Stock options (right to buy) 1.48 2015-05-20 4 A 0 100000 0 A 2025-05-20 Common Stock 100000 100000 D The option vests in five equal annual installments beginning on May 20, 2016. /s/ Norman Winland 2015-05-22