0000895930-16-000289.txt : 20161201
0000895930-16-000289.hdr.sgml : 20161201
20161201163542
ACCESSION NUMBER: 0000895930-16-000289
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20161201
FILED AS OF DATE: 20161201
DATE AS OF CHANGE: 20161201
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: HERR HENRY D
CENTRAL INDEX KEY: 0000903096
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36531
FILM NUMBER: 162028731
MAIL ADDRESS:
STREET 1: ONE BURTON HILLS BLVD
CITY: NASHVILLE
STATE: TN
ZIP: 37215
4
1
wf-form4_148062812921116.xml
FORM 4
X0306
4
2016-12-01
1
0000895930
AMSURG CORP
AMSG
0000903096
HERR HENRY D
110 31ST AVE NORTH, UNIT 1003
NASHVILLE
TN
37203
1
0
0
0
Common stock
2016-12-01
4
D
0
109666
D
0
D
5.250% Mandatory Convertible Preferred Stock, Series A-1
2016-12-01
4
D
0
400
D
2017-07-01
Common stock
400.0
0
D
Disposition pursuant to the terms of the Agreement and Plan of Merger, dated as of June 15, 2016, by and among Envision Healthcare Holdings,Inc., New Amethyst Corp. and AmSurg Corp. (the "Merger Agreement"), exempt under Rule 16b-3.
Pursuant to the terms of the Merger Agreement, at the Merger 1 Effective Time (as defined in the Merger Agreement), each share of common stock or preferred stock held by the reporting person immediately prior to the Merger 1 Effective Time was assumed by New Amethyst and converted into a New Amethyst share of common stock or preferred stock having the same terms and conditions, taking into account any changes thereto by reason of the Mergers (as defined in the Merger Agreement).
/s/ Henry D. Herr
2016-12-01