-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, KvPEsY1aMaJPnJMlf5Netn2y5hGc1u2nzWAkxtgblzXbVzt5v1ogpMfl9HBQxPNM 7Fr+lVmVsHLa3fARo8GvzQ== 0001193805-10-000250.txt : 20100126 0001193805-10-000250.hdr.sgml : 20100126 20100126190145 ACCESSION NUMBER: 0001193805-10-000250 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20100122 FILED AS OF DATE: 20100126 DATE AS OF CHANGE: 20100126 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: 5429 LYNDON B. JOHNSON FREEWAY STREET 2: SUITE 700 CITY: DALLAS STATE: TX ZIP: 75240 BUSINESS PHONE: 972-308-6830 MAIL ADDRESS: STREET 1: 5429 LYNDON B. JOHNSON FREEWAY STREET 2: SUITE 700 CITY: DALLAS STATE: TX ZIP: 75240 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: 10548781 MAIL ADDRESS: STREET 1: 1660 WALT WHITMAN ROAD STREET 2: SUITE 105 CITY: MELVILLE STATE: NY ZIP: 11747 4 1 e606351_ex.xml FORM 4 X0303 4 2010-01-22 0 0001316645 American Caresource Holdings, Inc. ANCI 0000897464 PAPPAJOHN JOHN C/O AMERICAN CARESOURCE HOLDINGS, INC. 5429 LYNDON B JOHNSON FREEWAY DALLAS TX 75240 1 0 0 0 Common Stock 2010-01-22 4 X 0 597435 0.40 A 4765730 D Common Stock 2010-01-22 4 J 0 98750 2.42 D 4666980 D Stock Purchase Warrant .40 2010-01-22 4 X 0 597435 0 D 2005-01-27 2010-01-27 Common Stock 597435 0 D On 1/22/2010, the Reporting Person effected a net issue exercise of a warrant to purchase 597,435 shares of common stock of the issuer. As a result, based on a closing price of the issuer's common stock of $2.42 per share on 1/21/2010, the Reporting Person received 498,685 shares of common stock upon exercise of the warrant, while 98,750 shares of common stock underlying the warrant were "withheld" in lieu of payment of the exercise price. /s/ John Pappajohn 2010-01-26 -----END PRIVACY-ENHANCED MESSAGE-----