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