0001433671-21-000002.txt : 20211004
0001433671-21-000002.hdr.sgml : 20211004
20211004162102
ACCESSION NUMBER: 0001433671-21-000002
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20211001
FILED AS OF DATE: 20211004
DATE AS OF CHANGE: 20211004
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Prosky Danny
CENTRAL INDEX KEY: 0001433671
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-55434
FILM NUMBER: 211303017
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 III, Inc.
CENTRAL INDEX KEY: 0001566912
STANDARD INDUSTRIAL CLASSIFICATION: REAL ESTATE INVESTMENT TRUSTS [6798]
IRS NUMBER: 461749436
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
4
1
wf-form4_163337881882160.xml
FORM 4
X0306
4
2021-10-01
1
0001566912
Griffin-American Healthcare REIT III, Inc.
NONE
0001433671
Prosky Danny
C/O GRIFFIN-AMERICAN HEALTHCARE REIT
III, INC., 18191 VON KARMAN AVE, STE 300
IRVINE
CA
92612
1
1
0
0
President & COO
Common Stock
2021-10-01
4
D
0
221748
D
0
I
By Danny and Zohar Prosky Family Trust, DTD 8/16/2011
Common Stock
2021-10-01
4
D
0
22222
D
0
I
By Griffin-American Healthcare REIT III Advisor, LLC
Reflects the disposition of shares of the Issuer's common stock in connection with the merger (the "Merger") of the Issuer with and into Continental Merger Sub, LLC, a wholly-owned subsidiary of American Healthcare REIT, Inc. ("AHR"). In the Merger, each share of the Issuer's common stock, par value $0.01 per share, was converted into the right to receive 0.9266 shares of AHR Class I common stock, par value $0.01 per share ("AHR Class I Common Stock"). There is no established market for shares of AHR Class I Common Stock. On March 18, 2021, the board of directors of AHR approved an estimated value per share of AHR Class I Common Stock of $9.22.
The reported shares of common stock are held directly by Danny & Zohar Prosky Family Trust, DTD 8/16/2011, and indirectly by Danny Prosky and Zohar Prosky, Trustees.
The reported shares of common stock are owned by Griffin-American Healthcare REIT III Advisor, LLC ("GAHRIII Advisor"), which is 75% owned and managed by wholly owned subsidiaries of American Healthcare Investors, LLC ("American Healthcare Investors"). Mr. Prosky serves as a managing director of American Healthcare Investors, and as such, may be deemed to be the beneficial owner of such common stock. Mr. Prosky disclaims beneficial ownership of the reported securities except to the extent of his pecuniary interest therein.
/s/ DANNY PROSKY
2021-10-04