0000899243-16-011252.txt : 20160107
0000899243-16-011252.hdr.sgml : 20160107
20160107125038
ACCESSION NUMBER: 0000899243-16-011252
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20151231
FILED AS OF DATE: 20160107
DATE AS OF CHANGE: 20160107
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: USMD Holdings, Inc.
CENTRAL INDEX KEY: 0001507881
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-GENERAL MEDICAL & SURGICAL HOSPITALS, NEC [8062]
IRS NUMBER: 272866866
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 6333 NORTH STATE HIGHWAY 161
STREET 2: SUITE 200
CITY: IRVING
STATE: TX
ZIP: 75038
BUSINESS PHONE: 214-493-4000
MAIL ADDRESS:
STREET 1: 6333 NORTH STATE HIGHWAY 161
STREET 2: SUITE 200
CITY: IRVING
STATE: TX
ZIP: 75038
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Cook Charles E.
CENTRAL INDEX KEY: 0001556960
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35639
FILM NUMBER: 161329655
MAIL ADDRESS:
STREET 1: 8440 WALNUT HILL LANE
STREET 2: SUITE 120
CITY: DALLAS
STATE: TX
ZIP: 75231
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2015-12-31
0
0001507881
USMD Holdings, Inc.
USMD
0001556960
Cook Charles E.
8440 WALNUT HILL LANE
SUITE 120
DALLAS
TX
75231
1
0
0
0
Common Stock ($.01 par)
2015-12-31
4
A
0
2099
7.98
A
29506
D
Common Stock ($.01 par)
140999
I
Indirectly held through UANT Ventures, L.P.
7.25% Convertible Subordinated Note due 2020
10.61
2016-04-29
Common Stock ($.01 par)
23563
23563
D
Represents stock compensation granted to reporting person under the 2010 USMD Holdings, Inc. Equity Compensation Plan for his services as a director for the period from October 2015 through December 2015.
The noteholder has the right, at any time after April 29, 2016 but prior to the payment in full of the note by the issuer, to convert all or any portion of the unpaid principal balance of the note into shares of the issuer's common stock. This conversion right expires on November 1, 2020, the maturity date of the note, or upon the earlier payment in full of of the principal balance of the note.
/s/ Charles E. Cook
2016-01-06