0001171843-15-002223.txt : 20150427
0001171843-15-002223.hdr.sgml : 20150427
20150427181409
ACCESSION NUMBER: 0001171843-15-002223
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20150424
FILED AS OF DATE: 20150427
DATE AS OF CHANGE: 20150427
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: American CareSource Holdings, Inc.
CENTRAL INDEX KEY: 0001316645
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MISC HEALTH & ALLIED SERVICES, NEC [8090]
IRS NUMBER: 200428568
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 1170 PEACHTREE STREET, NE
STREET 2: SUITE 2350
CITY: ATLANTA
STATE: GA
ZIP: 30309
BUSINESS PHONE: 972-308-6830
MAIL ADDRESS:
STREET 1: 1170 PEACHTREE STREET, NE
STREET 2: SUITE 2350
CITY: ATLANTA
STATE: GA
ZIP: 30309
FORMER COMPANY:
FORMER CONFORMED NAME: American Caresource Holdings, Inc.
DATE OF NAME CHANGE: 20050615
FORMER COMPANY:
FORMER CONFORMED NAME: American Caresouce Holdings, Inc.
DATE OF NAME CHANGE: 20050204
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: PAPPAJOHN JOHN
CENTRAL INDEX KEY: 0000897464
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-33094
FILM NUMBER: 15796203
MAIL ADDRESS:
STREET 1: 1660 WALT WHITMAN ROAD
STREET 2: SUITE 105
CITY: MELVILLE
STATE: NY
ZIP: 11747
4
1
gff4_pappajohn042715.xml
OWNERSHIP DOCUMENT
X0306
4
2015-04-24
0
0001316645
American CareSource Holdings, Inc.
ANCI
0000897464
PAPPAJOHN JOHN
C/O AMERICAN CARESOURCE HOLDINGS, INC.
1170 PEACHTREE STREET NE, SUITE 2350
ATLANTA
GA
30309
1
1
0
0
CEO and Chairman
Common Stock
2015-04-24
4
M
0
18744
0.933
A
2279398
D
Common Stock
5000
I
By Halkis, Ltd.
Common Stock
16791
I
By Equity Dynamics, Inc.
Stock option (right to buy)
0.933
2015-04-24
4
M
0
18744
0
D
2015-05-01
Common Stock
18744
0
D
The option became exercisable in 36 monthly installments beginning on May 1, 2005, which was the date on which the option was granted.
/s/ John Pappajohn
2015-04-27