0001316645-14-000017.txt : 20140507 0001316645-14-000017.hdr.sgml : 20140507 20140507172440 ACCESSION NUMBER: 0001316645-14-000017 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20140505 FILED AS OF DATE: 20140507 DATE AS OF CHANGE: 20140507 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: 14822130 MAIL ADDRESS: STREET 1: 1660 WALT WHITMAN ROAD STREET 2: SUITE 105 CITY: MELVILLE STATE: NY ZIP: 11747 4 1 wf-form4_139949786916247.xml FORM 4 X0306 4 2014-05-05 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, $0.01 par value per share 2014-05-05 4 P 0 575000 2 A 2292665 D Common Stock, $0.01 par value per share 5000 I By Spouse Common Stock, $0.01 par value per share 5000 I By Thebes, Ltd The shares of Common Stock were purchased directly from the Company in a private placement transaction. The Reporting Person disclaims beneficial interest over such shares except to the extent of his pecuniany interest. Thebes, Ltd is an entity solely owned by the Reporting Person's spouse. The Reporting Person disclaims beneficial interest over such shares except to the extent of his pecuniany interest. /s/ John Pappajohn 2014-05-07