Statement of Changes in Beneficial Ownership (4)
March 26 2015 - 7:41PM
Edgar (US Regulatory)
FORM 4
[ ]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue.
See
Instruction 1(b).
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0287
Estimated average burden
hours per response...
0.5
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Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
*
SALKA SUSAN R
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2. Issuer Name
and
Ticker or Trading Symbol
AMN HEALTHCARE SERVICES INC
[
AHS
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__
X
__ Director
_____ 10% Owner
__
X
__ Officer (give title below)
_____ Other (specify below)
President and CEO
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(Last)
(First)
(Middle)
12400 HIGH BLUFF DRIVE
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3. Date of Earliest Transaction
(MM/DD/YYYY)
3/24/2015
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(Street)
SAN DIEGO, CA 92130
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
_
X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security
(Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code
(Instr. 8)
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4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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Common Stock
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2/24/2015
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G
(1)
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V
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22000
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D
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$0.00
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388002
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D
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Common Stock
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3/24/2015
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M
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120949
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A
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$14.86
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508951
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D
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Common Stock
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3/24/2015
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S
(2)
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120949
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D
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$23.1295
(3)
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388002
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D
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Common Stock
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3/25/2015
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M
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61151
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A
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$14.86
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449153
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D
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Common Stock
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3/25/2015
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S
(4)
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61151
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D
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$23.3779
(5)
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388002
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D
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Common Stock
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3/26/2015
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M
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2900
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A
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$14.86
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390902
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D
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Common Stock
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3/26/2015
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S
(6)
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2900
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D
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$23.0032
(7)
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388002
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D
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Table II - Derivative Securities Beneficially Owned (
e.g.
, puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security
(Instr. 3)
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2. Conversion or Exercise Price of Derivative Security
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3. Trans. Date
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3A. Deemed Execution Date, if any
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4. Trans. Code
(Instr. 8)
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5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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6. Date Exercisable and Expiration Date
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7. Title and Amount of Securities Underlying Derivative Security
(Instr. 3 and 4)
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8. Price of Derivative Security
(Instr. 5)
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9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4)
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10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4)
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11. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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(A)
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(D)
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Date Exercisable
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Expiration Date
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Title
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Amount or Number of Shares
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Stock Options (right to buy)
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$14.86
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3/24/2015
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M
(8)
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120949
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(9)
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5/4/2015
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Common Stock
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120949
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$0.00
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64051
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D
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Stock Options (right to buy)
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$14.86
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3/25/2015
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M
(8)
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61151
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(9)
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5/4/2015
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Common Stock
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61151
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$0.00
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2900
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D
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Stock Options (right to buy)
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$14.86
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3/26/2015
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M
(8)
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2900
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(9)
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5/4/2015
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Common Stock
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2900
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$0.00
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0
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D
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Explanation of Responses:
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(
1)
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The reporting person gifted 22,000 shares of AMN Common Stock to an irrevocable donor advised fund for the purpose of making charitible donations.
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(
2)
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The sale of 120,949 shares reported in this row was effected pursuant to a Rule 10b5-1 trading plan adopted by the reporting person.
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(
3)
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The price reported in this row represents a weighted average price of $23.1295 per share. These shares were sold in multiple transactions at prices ranging from $23.00 to $23.30, inclusive. The reporting person undertakes to provide to the issuer, any security holder of the issuer, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price.
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(
4)
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The sale of 61,151 shares reported in this row was effected pursuant to a Rule 10b5-1 trading plan adopted by the reporting person.
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(
5)
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The price reported in this row represents a weighted average price of $23.3779 per share. These shares were sold in multiple transactions at prices ranging from $23.00 to $23.70, inclusive. The reporting person undertakes to provide to the issuer, any security holder of the issuer, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price.
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(
6)
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The sale of 2,900 shares reported in this row was effected pursuant to a Rule 10b5-1 trading plan adopted by the reporting person.
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(
7)
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The price reported in this row represents a weighted average price of $23.0032 per share. These shares were sold in multiple transactions at prices ranging from $23.00 to $23.01, inclusive. The reporting person undertakes to provide to the issuer, any security holder of the issuer, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price.
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(
8)
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The exercise of the derivative securities reported on this Form 4 was effected pursuant to a Rule 10b5-1 trading plan adopted by the reporting person.
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(
9)
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The Options to purchase shares of Common Stock were granted pursuant to the AMN Healthcare Services, Inc. Stock Option Plan. The shares vested in four equal installments on the first, second, third and fourth anniversary of the grant date.
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Reporting Owners
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Reporting Owner Name / Address
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Relationships
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Director
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10% Owner
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Officer
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Other
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SALKA SUSAN R
12400 HIGH BLUFF DRIVE
SAN DIEGO, CA 92130
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X
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President and CEO
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Signatures
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/s/ Susan R. Salka
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3/26/2015
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**
Signature of Reporting Person
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Date
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
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*
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If the form is filed by more than one reporting person,
see
Instruction 4(b)(v).
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**
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Intentional misstatements or omissions of facts constitute Federal Criminal Violations.
See
18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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Note:
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File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure.
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Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number.
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