0001171843-15-006756.txt : 20151211 0001171843-15-006756.hdr.sgml : 20151211 20151211124916 ACCESSION NUMBER: 0001171843-15-006756 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20151209 FILED AS OF DATE: 20151211 DATE AS OF CHANGE: 20151211 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: Winger Adam Sidney CENTRAL INDEX KEY: 0001611781 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-33094 FILM NUMBER: 151282720 MAIL ADDRESS: STREET 1: 3937 FOREST AVENUE CITY: BIRMINGHAM STATE: AL ZIP: 35213 4 1 formfour.xml OWNERSHIP DOCUMENT X0306 4 2015-12-09 0 0001316645 American CareSource Holdings, Inc. GNOW 0001611781 Winger Adam Sidney C/O AMERICAN CARESOURCE HOLDINGS, INC. 1170 PEACHTREE STREET NE, SUITE 2350 ATLANTA GA 30309 0 1 0 0 Interim CFO, GC, VP Acq. & Sec Stock option (right to buy) 0.70 2015-12-09 4 A 0 105000 0 A 2025-12-09 Common Stock 105000 105000 D The stock option vests as follows: (i) the option to purchase 21,000 shares of common stock, par value $0.01 per share (the "Common Stock"), vests on the first anniversary of the grant date and (ii) the option for the remaining 84,000 shares of Common Stock vests in equal monthly installments over the 48 months immediately following the first anniversary of the grant date. /s/Adam S. Winger 2015-12-11