Initial Statement of Beneficial Ownership (3)
March 18 2020 - 5:33PM
Edgar (US Regulatory)
FORM 3
|
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
|
OMB APPROVAL
OMB Number:
3235-0104
Estimated average burden
hours per response...
0.5
|
|
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
|
|
|
1. Name and Address of Reporting Person
*
DHC Holdings LLC |
2. Date of Event Requiring Statement (MM/DD/YYYY)
2/28/2020
|
3. Issuer Name and Ticker or Trading Symbol
FIVE STAR SENIOR LIVING INC. [NASDAQ:FVE]
|
|
(Last)
(First)
(Middle)
TWO NEWTON PLACE, 255 WASHINGTON STREET, SUITE 300 |
4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
_____ Director ___X___ 10% Owner
_____ Officer (give title below) _____ Other (specify below)
|
|
(Street)
NEWTON, MA 02458
(City)
(State)
(Zip)
| 5. If Amendment, Date Original Filed(MM/DD/YYYY)
| 6. Individual or Joint/Group Filing(Check Applicable Line)
_X_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
|
Table I - Non-Derivative Securities Beneficially Owned
|
1.Title of Security
(Instr. 4) | 2. Amount of Securities Beneficially Owned
(Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I)
(Instr. 5) | 4. Nature of Indirect Beneficial Ownership
(Instr. 5) |
| Common Stock | 8176025 | D | |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
|
1. Title of Derivate Security
(Instr. 4) | 2. Date Exercisable and Expiration Date
(MM/DD/YYYY) | 3. Title and Amount of Securities Underlying Derivative Security
(Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 5) | 6. Nature of Indirect Beneficial Ownership
(Instr. 5) |
| Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
| Explanation of Responses: |
Remarks:
Diversified Healthcare Trust ("DHC"), the Reporting Person's sole member, contributed the shares of common stock ("Common Shares") of the Issuer being reporting herein to the Reporting Person as a capital contribution on February 28, 2020. DHC continues to beneficially own the contributed Common Shares, as well as 2,515,633 additional Common Shares. |
Reporting Owners
|
| Reporting Owner Name / Address | Relationships |
| Director | 10% Owner | Officer | Other |
DHC Holdings LLC
TWO NEWTON PLACE
255 WASHINGTON STREET, SUITE 300
NEWTON, MA 02458 |
| X |
|
|
Signatures
|
| /s/ Richard W. Siedel, Jr. | | 3/18/2020 |
| **Signature of Reporting Person | Date |
Five Star Senior Living (NASDAQ:FVEVV)
Historical Stock Chart
From Apr 2024 to May 2024
Five Star Senior Living (NASDAQ:FVEVV)
Historical Stock Chart
From May 2023 to May 2024
