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AMS American Shared Hospital Services

3.03
-0.03 (-0.98%)
After Hours
Last Updated: 21:40:58
Delayed by 15 minutes
Share Name Share Symbol Market Type
American Shared Hospital Services AMEX:AMS AMEX Common Stock
  Price Change % Change Share Price High Price Low Price Open Price Shares Traded Last Trade
  -0.03 -0.98% 3.03 3.23 3.02 3.02 6,630 21:40:58

Statement of Changes in Beneficial Ownership (4)

07/12/2020 1:46pm

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).         
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
                                                                                  
OMB APPROVAL
OMB Number: 3235-0287
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 *

Stachowiak Raymond C
2. Issuer Name and Ticker or Trading Symbol

AMERICAN SHARED HOSPITAL SERVICES [ AMS ]
5. Relationship of Reporting Person(s) to Issuer (Check all applicable)

__X__ Director                    __X__ 10% Owner
__X__ Officer (give title below)    _____ Other (specify below)
CEO
(Last)          (First)          (Middle)

C/O ASHS, TWO EMBARCADERO CENTER, STE 410
3. Date of Earliest Transaction (MM/DD/YYYY)

12/4/2020
(Street)

SAN FRANCISCO, CA 94111-4107
(City)        (State)        (Zip)
4. 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 Acquired, Disposed of, or Beneficially Owned
1.Title of Security
(Instr. 3)
2. Trans. Date 2A. Deemed Execution Date, if any 3. Trans. Code
(Instr. 8)
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock, No Par Value (1)12/4/2020  A  10000 A$0 178061 D  
Common Stock, No Par Value         57000 I By RCS Investments Inc. 
Common Stock, No Par Value         760559 I By Stachowiak Equity Fund LLC 

Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivate Security
(Instr. 3)
2. Conversion or Exercise Price of Derivative Security3. Trans. Date3A. Deemed Execution Date, if any4. Trans. Code
(Instr. 8)
5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
6. Date Exercisable and Expiration Date7. Title and Amount of Securities Underlying Derivative Security
(Instr. 3 and 4)
8. Price of Derivative Security
(Instr. 5)
9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4)10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4)11. Nature of Indirect Beneficial Ownership (Instr. 4)
CodeV(A)(D)Date ExercisableExpiration DateTitleAmount or Number of Shares

Explanation of Responses:
(1) This represents an award of 10,000 Restricted Stock Units. Each unit will entitle the reporting person to one share of the issuer's Common Stock upon vesting. The units will vest in full on January 3, 2021.

Reporting Owners
Reporting Owner Name / Address
Relationships
Director10% OwnerOfficerOther
Stachowiak Raymond C
C/O ASHS
TWO EMBARCADERO CENTER, STE 410
SAN FRANCISCO, CA 94111-4107
XXCEO

Signatures
/s/ Craig K. Tagawa on behalf of Raymond C. Stachowiak12/1/2020
**Signature of Reporting PersonDate

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