0001567619-21-000544.txt : 20210106 0001567619-21-000544.hdr.sgml : 20210106 20210106162953 ACCESSION NUMBER: 0001567619-21-000544 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210104 FILED AS OF DATE: 20210106 DATE AS OF CHANGE: 20210106 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Hays Michael D. CENTRAL INDEX KEY: 0001053133 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35929 FILM NUMBER: 21510979 MAIL ADDRESS: STREET 1: C/O NATIONAL RESEARCH CORPORATION STREET 2: 1245 Q STREET CITY: LINCOLN STATE: NE ZIP: 68508 FORMER NAME: FORMER CONFORMED NAME: HAYS MICHAEL DATE OF NAME CHANGE: 19980115 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 X0306 4 2021-01-04 0 0000070487 NATIONAL RESEARCH CORP NRC 0001053133 Hays Michael D. C/O NATIONAL RESEARCH CORP 1245 Q STREET LINCOLN NE 68508 1 1 0 0 CEO & President Common Stock 2021-01-04 4 M 0 17745 9.14 A 57749 D Common Stock 139095 I By Spouse Employee Stock Option (right to buy) 9.14 2021-01-04 4 M 0 17745 0 D 2021-01-05 Common Stock 17745 0 D Employee Stock Option (right to buy) 42.92 2021-01-05 4 A 0 4452 0 A 2031-01-05 Common Stock 4452 4452 D The reporting person disclaims beneficial ownership of these shares. This option became fully exercisable on January 5, 2016 This option becomes fully exercisable on January 5, 2026. /s/ Michael D. Hays, by Christopher Kortum, attorney-in-fact, pursuant to a POA previously filed with the SEC 2021-01-06