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FVEVV Five Star Senior Living Inc

4.40
0.00 (0.00%)
Last Updated: 00:00:00
Delayed by 15 minutes
Share Name Share Symbol Market Type
Five Star Senior Living Inc NASDAQ:FVEVV NASDAQ Common Stock
  Price Change % Change Share Price Bid Price Offer Price High Price Low Price Open Price Shares Traded Last Trade
  0.00 0.00% 4.40 0.0001 4.80 0 00:00:00

Statement of Changes in Beneficial Ownership (4)

02/01/2020 10:34pm

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 *

POTTER KATHERINE E.
2. Issuer Name and Ticker or Trading Symbol

FIVE STAR SENIOR LIVING INC. [ NASDAQ:FVE ]
5. Relationship of Reporting Person(s) to Issuer (Check all applicable)

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

C/O FIVE STAR SENIOR LIVING INC.,, 400 CENTRE STREET
3. Date of Earliest Transaction (MM/DD/YYYY)

1/1/2020
(Street)

NEWTON, MA 02458
(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 1/1/2020  J(1)  623 A$0 (1)30223 D  

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) In connection with a Transaction Agreement, dated as of April 1, 2019, between Diversified Healthcare Trust (formerly known as Senior Housing Properties Trust) ("DHC") and Five Star Senior Living Inc. (the "Issuer"), effective January 1, 2020, DHC completed a pro rata distribution to holders of record of DHC's common shares of beneficial interest as of December 13, 2019 of the right to receive an aggregate of approximately 16,119,563 shares of common stock of the Issuer ("Common Shares"), with cash being paid in lieu of fractional shares. The reporting person received the Common Shares reported in her capacity as a shareholder of DHC.

Reporting Owners
Reporting Owner Name / Address
Relationships
Director10% OwnerOfficerOther
POTTER KATHERINE E.
C/O FIVE STAR SENIOR LIVING INC.,
400 CENTRE STREET
NEWTON, MA 02458


President and CEO

Signatures
/s/ Katherine E. Potter1/2/2020
**Signature of Reporting PersonDate

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