0001628280-22-001400.txt : 20220127 0001628280-22-001400.hdr.sgml : 20220127 20220127195349 ACCESSION NUMBER: 0001628280-22-001400 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220127 FILED AS OF DATE: 20220127 DATE AS OF CHANGE: 20220127 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Stapley Gregory K. CENTRAL INDEX KEY: 0001417559 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36181 FILM NUMBER: 22564902 MAIL ADDRESS: STREET 1: 27101 PUERTA REAL, SUITE 450 CITY: MISSION VIEJO STATE: CA ZIP: 92691 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: CareTrust REIT, Inc. CENTRAL INDEX KEY: 0001590717 STANDARD INDUSTRIAL CLASSIFICATION: REAL ESTATE INVESTMENT TRUSTS [6798] IRS NUMBER: 463999490 STATE OF INCORPORATION: MD FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 905 CALLE AMANECER, SUITE 300 CITY: SAN CLEMENTE STATE: CA ZIP: 92673 BUSINESS PHONE: (949) 542-3140 MAIL ADDRESS: STREET 1: 905 CALLE AMANECER, SUITE 300 CITY: SAN CLEMENTE STATE: CA ZIP: 92673 4 1 wf-form4_164333121381907.xml FORM 4 X0306 4 2022-01-27 0 0001590717 CareTrust REIT, Inc. CTRE 0001417559 Stapley Gregory K. 905 CALLE AMANECER SUITE 300 SAN CLEMENTE CA 92673 1 1 0 0 Executive Chairman Common Stock 2022-01-27 4 F 0 5318 20.55 D 413973 D Common Stock 527537 I Stapley Family Trust dated 4/25/2006 Common Stock 14336 I By wife as UGMA custodian for children Common Stock 14336 I By son Represents shares of common stock withheld by the Issuer to pay tax withholding obligations of the Reporting Person upon vesting of restricted stock granted to the Reporting Person. These shares are directly owned by the Stapley Family Trust dated 4/25/2006 and indirectly by Gregory K. Stapley as Trustee of the Trust. Gregory K. Stapley is an officer of the Issuer. These shares are directly owned by Deborah Stapley as custodian for the minor children of Gregory K. Stapley and Deborah Stapley under the California Uniform Transfers to Minors Act. Gregory K. Stapley is an officer of the Issuer. The Reporting Person disclaims beneficial ownership of the shares owned by his children, and this report should not be deemed an admission that the Reporting Person is the beneficial owner of such shares for the purposes of Section 16 or any other purpose. /s/ William M. Wagner, attorney-in-fact 2022-01-27