0001705113-17-000004.txt : 20170615
0001705113-17-000004.hdr.sgml : 20170615
20170615163207
ACCESSION NUMBER: 0001705113-17-000004
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20170613
FILED AS OF DATE: 20170615
DATE AS OF CHANGE: 20170615
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
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Flornes Brian J.
CENTRAL INDEX KEY: 0001705113
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-55775
FILM NUMBER: 17913851
MAIL ADDRESS:
STREET 1: 1613 SUNSET RIDGE DRIVE
CITY: LAGUNA BEACH
STATE: CA
ZIP: 92651
4
1
wf-form4_149755867654083.xml
FORM 4
X0306
4
2017-06-13
0
0001632970
Griffin-American Healthcare REIT IV, Inc.
NONE
0001705113
Flornes Brian J.
C/O GRIFFIN-AMERICAN HEALTHCARE REIT IV,
INC., 18191 VON KARMAN AVE., STE. 300
IRVINE
CA
92612
1
0
0
0
Class T Common Stock
2017-06-13
4
A
0
2500
0
A
7500
D
Upon his re-election as an independent director to the board of directors of the Issuer on June 13, 2017, Mr. Flornes was granted 2,500 shares of restricted Class T common stock. The shares of restricted Class T common stock vested immediately as to 20.0% of the shares on the grant date, and the remainder vests on each anniversary thereafter over four years.
/s/ BRIAN J. FLORNES
2017-06-15