0000950103-17-000233.txt : 20170106
0000950103-17-000233.hdr.sgml : 20170106
20170106175531
ACCESSION NUMBER: 0000950103-17-000233
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20170104
FILED AS OF DATE: 20170106
DATE AS OF CHANGE: 20170106
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: AMERICAN SHARED HOSPITAL SERVICES
CENTRAL INDEX KEY: 0000744825
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MEDICAL LABORATORIES [8071]
IRS NUMBER: 942918118
STATE OF INCORPORATION: CA
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 2 EMBARCADERO CENTER
STREET 2: SUITE 410
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94111
BUSINESS PHONE: 415-788-5300
MAIL ADDRESS:
STREET 1: 2 EMBARCADERO CENTER
STREET 2: SUITE 410
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94111
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: BATES ERNEST A
CENTRAL INDEX KEY: 0000946042
STATE OF INCORPORATION: CA
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-08789
FILM NUMBER: 17515347
MAIL ADDRESS:
STREET 1: FOUR EMBARCADERO CENTER 3620
CITY: SAN FRANCISO
STATE: CA
ZIP: 94111-4155
4
1
dp71778_4-bates.xml
FORM 4
X0306
4
2017-01-04
0
0000744825
AMERICAN SHARED HOSPITAL SERVICES
AMS
0000946042
BATES ERNEST A
TWO EMBARCADERO CENTER, SUITE 410
SAN FRANCISO
CA
94111
1
1
1
0
Chairman and CEO
Common Stock
2017-01-04
4
A
0
66177
0.00
A
655147
D
Represents 66,177 performance shares granted to the Reporting Person on January 4, 2017, which vest upon the Issuer's achievement of pre-determined sales, earnings and related metrics before March 31, 2020.
/s/ Chloe Tagawa on behalf of Ernest A. Bates
2017-01-06