0001104659-21-083609.txt : 20210621 0001104659-21-083609.hdr.sgml : 20210621 20210621172654 ACCESSION NUMBER: 0001104659-21-083609 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210617 FILED AS OF DATE: 20210621 DATE AS OF CHANGE: 20210621 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Smith Thomas Andrew CENTRAL INDEX KEY: 0001377740 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-55190 FILM NUMBER: 211032050 MAIL ADDRESS: STREET 1: 111 WESTWOOD PLACE, SUITE 400 CITY: BRENTWOOD STATE: TN ZIP: 37027 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: NorthStar Healthcare Income, Inc. CENTRAL INDEX KEY: 0001503707 STANDARD INDUSTRIAL CLASSIFICATION: REAL ESTATE INVESTMENT TRUSTS [6798] IRS NUMBER: 273663988 STATE OF INCORPORATION: MD FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 590 MADISON AVENUE, 34TH FLOOR STREET 2: 18TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10022 BUSINESS PHONE: 212-547-2600 MAIL ADDRESS: STREET 1: 590 MADISON AVENUE, 34TH FLOOR STREET 2: 18TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10022 FORMER COMPANY: FORMER CONFORMED NAME: NorthStar Healthcare Income Trust, Inc. DATE OF NAME CHANGE: 20120404 FORMER COMPANY: FORMER CONFORMED NAME: NorthStar Senior Care Trust, Inc. DATE OF NAME CHANGE: 20101119 FORMER COMPANY: FORMER CONFORMED NAME: NorthStar Healthcare Trust, Inc. DATE OF NAME CHANGE: 20101018 4 1 tm2120085d3_4.xml OWNERSHIP DOCUMENT X0306 4 2021-06-17 0 0001503707 NorthStar Healthcare Income, Inc. NONE 0001377740 Smith Thomas Andrew C/O NORTHSTAR HEALTHCARE INCOME, INC. 590 MADISON AVENUE, 34TH FLOOR NEW YORK NY 10022 1 0 0 0 Common Stock 2021-06-17 4 A 0 16710 A 35465 D Pursuant to the NorthStar Healthcare Income, Inc. (the "Company") Fourth Amended and Restated Independent Directors Compensation Plan (the "Plan"), each of the Company's independent directors receives a grant of $65,000 in restricted stock units ("Restricted Stock Units") convertible, on a one-for-one-basis, into common stock, par value $0.01, of the Company (the "Common Stock") following re-election to the Company's Board of Directors. The Restricted Stock Units vest quarterly over a two year period with an initial vesting date of July 1, 2021. Unless forfeited prior to the applicable vesting date, the Restricted Stock Units will be converted into shares of Common Stock on the earlier of (i) Change in Control (as defined in Section 409A of the Code) or (ii) the date of the director's "separation from service" (as defined in Section 409A of the Code). Pursuant to the Plan, the amount of Restricted Stock Units was determined by dividing the fixed grant value of $65,000 by the most recently disclosed net asset value of the Company's common stock, or $3.89. /s/ Ann B. Harrington, as Attorney-in-Fact 2021-06-21