0000895930-16-000099.txt : 20160201 0000895930-16-000099.hdr.sgml : 20160201 20160201180640 ACCESSION NUMBER: 0000895930-16-000099 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20151231 FILED AS OF DATE: 20160201 DATE AS OF CHANGE: 20160201 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: AMSURG CORP CENTRAL INDEX KEY: 0000895930 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-OFFICES & CLINICS OF DOCTORS OF MEDICINE [8011] IRS NUMBER: 621493316 STATE OF INCORPORATION: TN FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1A BURTON HILLS BLVD. CITY: NASHVILLE STATE: TN ZIP: 37215 BUSINESS PHONE: 615-665-1283 MAIL ADDRESS: STREET 1: 1A BURTON HILLS BLVD. CITY: NASHVILLE STATE: TN ZIP: 37215 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Clendenin Phillip A CENTRAL INDEX KEY: 0001459541 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36531 FILM NUMBER: 161378622 MAIL ADDRESS: STREET 1: 20 BURTON HILLS BOULEVARD CITY: NASHVILLE STATE: TN ZIP: 37215 5 1 wf-form5_145436798917643.xml FORM 5 X0306 5 2015-12-31 0 0 0 0000895930 AMSURG CORP AMSG 0001459541 Clendenin Phillip A 1A BURTON HILLS BLVD NASHVILLE TN 37215 0 1 0 0 President Ambulatory Services Common stock 40908 D Restricted stock units Common stock 3452.0 0 D Each restricted stock unit represents a contingent right to receive between .50 and 1.50 shares of AmSurg Corp. common stock. Performance-based RSUs awarded on February 3, 2015 that may be earned only to the extent the established performance criteria are met. These RSUs vest in three equal annual installments. This amount represents the total number of derivative securities beneficially owned of the class shown. /s/ Phillip A. Clendenin 2016-02-01