0001209191-13-036669.txt : 20130715
0001209191-13-036669.hdr.sgml : 20130715
20130715174026
ACCESSION NUMBER: 0001209191-13-036669
CONFORMED SUBMISSION TYPE: 4/A
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20130711
FILED AS OF DATE: 20130715
DATE AS OF CHANGE: 20130715
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: ASSISTED LIVING CONCEPTS INC
CENTRAL INDEX KEY: 0000929994
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-NURSING & PERSONAL CARE FACILITIES [8050]
IRS NUMBER: 931148702
STATE OF INCORPORATION: NV
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: W140 N8981 LILLY ROAD
CITY: MENOMONEE FALLS
STATE: WI
ZIP: 53051
BUSINESS PHONE: 262-257-8888
MAIL ADDRESS:
STREET 1: W140 N8981 LILLY ROAD
CITY: MENOMONEE FALLS
STATE: WI
ZIP: 53051
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Zak Kowalczyk Mary
CENTRAL INDEX KEY: 0001508729
FILING VALUES:
FORM TYPE: 4/A
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-13498
FILM NUMBER: 13969012
MAIL ADDRESS:
STREET 1: W140 N8981 LILLY ROAD
CITY: MENOMONEE FALLS
STATE: WI
ZIP: 53051
4/A
1
doc4a.xml
FORM 4/A SUBMISSION
X0306
4/A
2013-07-11
2013-07-11
1
0000929994
ASSISTED LIVING CONCEPTS INC
ALC
0001508729
Zak Kowalczyk Mary
608 REDTAIL LANE
COLGATE
WI
53017
0
1
0
0
Vice President
Class A Common Stock
2013-07-11
4
D
0
1334
12.00
D
0
D
Tandem Stock Options/SARs (right to buy)
7.68
2013-07-11
4
D
0
2666
4.33
D
2014-02-22
Class A Common Stock
2666
0
D
Tandem Stock Options/SARs (right to buy)
15.86
2013-07-11
4
D
0
2000
0.00
D
2015-03-03
Class A Common Stock
2000
0
D
Tandem Stock Options/SARs (right to buy)
18.69
2013-07-11
4
D
0
11000
0.00
D
2016-03-02
Class A Common Stock
11000
0
D
Tandem Stock Options/SARs (right to buy)
17.01
2013-07-11
4
D
0
2200
0.00
D
2017-03-15
Class A Common Stock
2200
0
D
Pursuant to the Agreement and Plan of Merger (the "Merger Agreement") dated as of February 25, 2013 among Aid Holdings, LLC, Aid Merger Sub, LLC and Assisted Living Concepts, Inc. ("ALC"), on July 11, 2013, each share of Class A Common Stock of ALC was converted into the right to receive $12.00 in cash.
Pursuant to the Merger Agreement, on July 11, 2013, each Tandem Stock Option/SAR (whether or not then exercisable or vested), which began vesting in three equal annual installments beginning on the date four years prior to its expiration date, was cancelled and converted into the right to receive a cash payment in an amount equal to the excess, if any, of $12.00 over the exercise price of such Tandem Stock Option/SAR.
Reason for Amendment: The box next to "Check this box if no longer subject to Section 16. . ." should have been checked.
/s/ Mary Zak-Kowalczyk
2013-07-11