0001316645-14-000048.txt : 20140801
0001316645-14-000048.hdr.sgml : 20140801
20140801205345
ACCESSION NUMBER: 0001316645-14-000048
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20140730
FILED AS OF DATE: 20140801
DATE AS OF CHANGE: 20140801
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: 141011275
MAIL ADDRESS:
STREET 1: 1660 WALT WHITMAN ROAD
STREET 2: SUITE 105
CITY: MELVILLE
STATE: NY
ZIP: 11747
4
1
wf-form4_140694081491603.xml
FORM 4
X0306
4
2014-07-30
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
Warrant to Purchase Common Stock
3.15
2014-07-30
4
A
0
440000
A
2014-07-30
2019-10-30
Common Stock
440000.0
440000
D
Issued in consideration for providing a guarantee to a lender of up to $2.75 million for a line of credit rendered to the company.
/s/ John Pappajohn
2014-08-01