0001193805-11-002327.txt : 20111207
0001193805-11-002327.hdr.sgml : 20111207
20111207163758
ACCESSION NUMBER: 0001193805-11-002327
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20111205
FILED AS OF DATE: 20111207
DATE AS OF CHANGE: 20111207
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: 111248923
MAIL ADDRESS:
STREET 1: 1660 WALT WHITMAN ROAD
STREET 2: SUITE 105
CITY: MELVILLE
STATE: NY
ZIP: 11747
4
1
e609138_ex.xml
X0304
4
2011-12-05
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, $0.01 par value per share
2011-12-05
4
P
0
69730
.3838
A
5011959
D
Common Stock, $0.01 par value per share
2011-12-06
4
P
0
100
.39
A
5012059
D
Common Stock, $0.01 par value per share
65375
I
See Footnote
Common Stock, $0.01 par value per share
30000
I
See Footnote
Includes 3,333 restricted stock units, not all of which have vested.
Held by entities solely owned by the Reporting Person.
Held by Reporting Person's spouse and entity solely owned by Reporting Peron's spouse.
/s/ John Pappajohn
2011-12-07