0001140361-12-006052.txt : 20120207 0001140361-12-006052.hdr.sgml : 20120207 20120207185918 ACCESSION NUMBER: 0001140361-12-006052 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20120105 FILED AS OF DATE: 20120207 DATE AS OF CHANGE: 20120207 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Henricks Susan L CENTRAL INDEX KEY: 0001524893 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-29466 FILM NUMBER: 12579346 MAIL ADDRESS: STREET 1: C/O NATIONAL RESEARCH CORPORATION STREET 2: 1245 Q STREET CITY: LINCOLN STATE: NE ZIP: 68508 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: NATIONAL RESEARCH CORP CENTRAL INDEX KEY: 0000070487 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMMERCIAL PHYSICAL & BIOLOGICAL RESEARCH [8731] IRS NUMBER: 470634000 STATE OF INCORPORATION: WI FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1245 Q STREET CITY: LINCOLN STATE: NE ZIP: 68508 BUSINESS PHONE: 4024752525 MAIL ADDRESS: STREET 1: 1245 Q STREET CITY: LINCOLN STATE: NE ZIP: 68508 4 1 doc1.xml FORM 4 X0304 4 2012-01-05 0 0000070487 NATIONAL RESEARCH CORP NRCI 0001524893 Henricks Susan L C/O NATIONAL RESEARCH CORPORATION 1245 Q STREET LINCOLN NE 68508 0 1 0 0 President and COO Common Stock 2012-01-05 4 A 0 7823 0 A 7823 D Employee Stock Option (right to buy) 42.00 2021-07-05 Common Stock 50000 50000 D Restricted stock granted January 5, 2012 vests and becomes fully exercisable on January 5, 2017. This option becomes fully exercisable on July 5, 2016. /s/ Russell E. Ryba, Attorney-in-Fact for Susan L. Henricks 2012-02-07