0001316645-13-000027.txt : 20130604 0001316645-13-000027.hdr.sgml : 20130604 20130604060123 ACCESSION NUMBER: 0001316645-13-000027 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20130530 FILED AS OF DATE: 20130604 DATE AS OF CHANGE: 20130604 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: 13889652 MAIL ADDRESS: STREET 1: 1660 WALT WHITMAN ROAD STREET 2: SUITE 105 CITY: MELVILLE STATE: NY ZIP: 11747 4 1 wf-form4_137034007171270.xml FORM 4 X0306 4 2013-05-30 0 0001316645 American Caresource Holdings, Inc. ANCI 0000897464 PAPPAJOHN JOHN C/O AMERICAN CARESOURCE HOLDINGS, INC. 5429 LYNDON B JOHNSON FREEWAY, SUITE 850 DALLAS TX 75240 1 0 0 0 Common Stock 2013-05-30 4 A 0 10000 0 A 1722865 D This is a grant of restricted stock units. Total amount held includes 10,215 unvested restricted stock units, of which 10,000 vest monthly over 24 months. Amount also includes 5,000 shares owned by the reporting person's spouse and 5,000 shares owned by Thebes, Ltd (an entity solely owned by the reporting person's spouse). Mr. Pappajohn disclaims beneficial interest over such shares except to the extent of his pecuniary interest therein. /s/ John Pappajohn 2013-06-03