- Statement of Changes in Beneficial Ownership (4)
March 14 2012 - 5:09PM
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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Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public
Utility Holding Company Act of 1935 or Section 30(f) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
*
McCurdy Chad A.
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2. Issuer Name
and
Ticker or Trading Symbol
ADVOCAT INC
[
AVCA
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__
X
__ Director
__
X
__ 10% Owner
_____ Officer (give title below)
_____ Other (specify below)
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(Last)
(First)
(Middle)
1621 GALLERIA BLVD
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3. Date of Earliest Transaction
(MM/DD/YYYY)
3/12/2012
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(Street)
BRENTWOOD, TN 37027
(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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3/12/2012
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A
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333
(1)
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A
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$
0
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583
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D
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Common Stock
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3/12/2012
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M
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3
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A
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$
0
(2)
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586
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D
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Common Stock
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105000
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I
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Jointly Held with Spouse
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Common Stock
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1017600
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I
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Owned by Marlin Capital Partners, LLC
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Common Stock
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5000
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I
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Owned by Dependent Child
(3)
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Common Stock
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14200
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I
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In IRA
(4)
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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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Dividend Equivalent Rights on 2011 Restricted Stock
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(5)
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3/12/2012
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M
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3
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(5)
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(5)
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Common Stock
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3
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$
0
(2)
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5.78
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D
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Stock Settled Stock Appreciation Right
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$5.45
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(6)
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6/18/2020
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Common Stock
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1000
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1000
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D
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Stock Settled Stock Appreciation Right
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$2.37
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(6)
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3/13/2019
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Common Stock
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1000
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1000
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D
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Stock Options (right to buy)
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$10.8
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(6)
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3/12/2018
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Common Stock
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15000
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15000
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D
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Explanation of Responses:
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(
1)
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Restricted stock grant that will vest in equal parts over the first three anniversaries of the date of grant.
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(
2)
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Represents vesting of Dividend Equivalent Rights on 2011 Restricted Stock.
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(
3)
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Mr. McCurdy is the Managing Partner of Marlin Capital Partners, LLC.
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(
4)
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This reporting person disclaims beneficial ownership of shares held by his child except to the extent of his pecuniary interest therein.
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(
5)
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These dividend equivalent rights accrued on shares of restricted stock granted on March 11, 2011 and will vest as the underlying shares vest.
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(
6)
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Vests 1/3 on the first anniversary of the date of grant, 1/3 on the second anniversary of the date of grant, and 1/3 on the third anniversary of the date of grant.
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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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McCurdy Chad A.
1621 GALLERIA BLVD
BRENTWOOD, TN 37027
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X
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X
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Signatures
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/s/ Sam Daniel, Attorney-In-Fact
for Chad A. McCurdy
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3/14/2012
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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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