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