0001567619-22-003867.txt : 20220214 0001567619-22-003867.hdr.sgml : 20220214 20220214095731 ACCESSION NUMBER: 0001567619-22-003867 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211231 FILED AS OF DATE: 20220214 DATE AS OF CHANGE: 20220214 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Hays Michael D. CENTRAL INDEX KEY: 0001053133 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35929 FILM NUMBER: 22626479 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: DE 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 5 1 doc1.xml FORM 5 X0306 5 2021-12-31 0 0 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 2021-08-31 5 G 0 10000 0 D 118595 I By Spouse Common Stock 2021-11-04 5 G 0 16500 0 D 102095 I By Spouse Common Stock 2021-12-29 5 G 0 10000 0 D 34102 D The reporting person disclaims beneficial ownership of these shares. /s/ Michael D. Hays, by Christopher Kortum, attorney-in-fact, pursuant to a POA previously filed with the SEC 2022-02-14