0001371918-17-000033.txt : 20171211 0001371918-17-000033.hdr.sgml : 20171211 20171211150152 ACCESSION NUMBER: 0001371918-17-000033 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20171207 FILED AS OF DATE: 20171211 DATE AS OF CHANGE: 20171211 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Hanson Jeffrey T CENTRAL INDEX KEY: 0001371918 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-55775 FILM NUMBER: 171249350 MAIL ADDRESS: STREET 1: 18191 VON KARMAN AVENUE STREET 2: SUITE 300 CITY: IRVINE STATE: CA ZIP: 92612 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Griffin-American Healthcare REIT IV, Inc. CENTRAL INDEX KEY: 0001632970 STANDARD INDUSTRIAL CLASSIFICATION: REAL ESTATE INVESTMENT TRUSTS [6798] IRS NUMBER: 472887436 STATE OF INCORPORATION: MD FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 18191 VON KARMAN AVENUE STREET 2: SUITE 300 CITY: IRVINE STATE: CA ZIP: 92612 BUSINESS PHONE: 949-270-9200 MAIL ADDRESS: STREET 1: 18191 VON KARMAN AVENUE STREET 2: SUITE 300 CITY: IRVINE STATE: CA ZIP: 92612 FORMER COMPANY: FORMER CONFORMED NAME: Griffin-American Healthcare REIT 4, Inc. DATE OF NAME CHANGE: 20150428 FORMER COMPANY: FORMER CONFORMED NAME: Griffin-American Healthcare REIT IV, Inc. DATE OF NAME CHANGE: 20150205 4 1 wf-form4_151302249409741.xml FORM 4 X0306 4 2017-12-07 0 0001632970 Griffin-American Healthcare REIT IV, Inc. NONE 0001371918 Hanson Jeffrey T C/O GRIFFIN-AMERICAN HEALTHCARE REIT IV, INC., 18191 VON KARMAN AVE., STE. 300 IRVINE CA 92612 1 1 0 0 CEO & Chairman of the Board Class I Common Stock 2017-12-07 4 P 0 1259 9.21 A 26212 I By Jeffrey T Hanson and April L Hanson Family Rev Trust DTD 06/14/2005 Class T Common Stock 2188 D Class T Common Stock 20206 I By Jeffrey T Hanson and April L Hanson Family Rev Trust DTD 06/14/2005 Class T Common Stock 1458 I By April Hanson IRA Class T Common Stock 2917 I By Crescentridge Inc 401K Plan Class T Common Stock 19479 I By JTH Holdings LLC DBPP Class T Common Stock 20833 I By Griffin-American Healthcare REIT IV Advisor, LLC The reported shares of Class I common stock were acquired at $9.21 per share by Mr. Hanson pursuant to an Executive Stock Purchase Plan between Mr. Hanson and the Issuer, entered into on 12/30/2016. The reported shares of Class I common stock are held directly by Jeffrey T Hanson and April L Hanson Family Rev Trust DTD 06/14/2005, and indirectly by Mr. Hanson and April L Hanson, Trustees. The reported shares of Class T common stock are held directly by Jeffrey T Hanson and April L Hanson Family Rev Trust DTD 06/14/2005, and indirectly by Mr. Hanson and April L Hanson, Trustees. The reported shares of Class T common stock are owned by April Hanson through her investment retirement account. April Hanson is the wife of the reporting person. The reported shares of Class T common stock are owned by Mr. Hanson through his 401(k) plan. The reported shares of Class T common stock are held directly in a defined benefit pension plan, of which Mr. Hanson serves as Trustee. The reported shares of Class T common stock are owned by Griffin-American Healthcare REIT IV Advisor, LLC ("GAHRIV Advisor"). Mr. Hanson serves as a managing director of American Healthcare Investors, LLC, the managing member of GAHRIV Advisor, and as such, may be deemed to be the beneficial owner of such common stock. Mr. Hanson disclaims beneficial ownership of the reported securities except to the extent of his pecuniary interest therein. /s/ JEFFREY T. HANSON 2017-12-11