- Statement of Changes in Beneficial Ownership (4)
30 Oktober 2008 - 7:48PM
Edgar (US Regulatory)
FORM 4
[
X
]
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
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3235-0287
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February 28, 2011
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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
*
MASTROVICH LAWRENCE A
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2. Issuer Name
and
Ticker or Trading Symbol
APRIA HEALTHCARE GROUP INC
[
AHG
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director
_____ 10% Owner
__
X
__ Officer (give title below)
_____ Other (specify below)
President and COO
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(Last)
(First)
(Middle)
C/O APRIA HEALTHCARE GROUP INC., 26220 ENTERPRISE COURT
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3. Date of Earliest Transaction
(MM/DD/YYYY)
10/28/2008
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(Street)
LAKE FOREST, CA 92630
(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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10/28/2008
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J
(1)
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50433
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D
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(1)
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0
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D
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Common Stock
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10/28/2008
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J
(2)
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40000
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D
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(2)
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0
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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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Restricted Stock Units
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$0
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10/28/2008
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J
(3)
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11667
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(3)
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12/31/2008
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Common Stock
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11667
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(3)
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0
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D
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Restricted Stock Units
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$0.001
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10/28/2008
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J
(4)
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39953
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(4)
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2/16/2010
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Common Stock
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39953
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(4)
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0
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D
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Restricted Stock Units
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$0.001
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10/28/2008
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J
(5)
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46960
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(5)
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12/31/2010
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Common Stock
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46960
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(5)
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0
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D
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Restricted Stock Purchase Right (Right to Buy)
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$7.60
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10/28/2008
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J
(6)
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23000
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12/13/2010
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2/15/2014
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Common Stock
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23000
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(6)
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0
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D
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Restricted Stock Purchase Right (Right to Buy)
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$6.46
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10/28/2008
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J
(6)
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15000
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6/30/2008
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8/12/2013
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Common Stock
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15000
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(6)
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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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Canceled pursuant to the Agreement and Plan of Merger, dated as of June 18, 2008 (the "Merger Agreement"), by and among the Issuer, Sky Acquisition LLC and Sky Merger Sub Corporation and converted into the right to receive a cash payment of $21.00 per share.
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(
2)
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These restricted shares, which were scheduled to vest on 12/31/2011, were canceled pursuant to the terms of the Merger Agreement and the plan under which they were issued in exchange for a cash payment of $21.00 per share.
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(
3)
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These restricted stock units, which were scheduled to vest on 12/31/2008, were canceled pursuant to the terms of the Merger Agreement and the plan under which they were issued in exchange for a cash payment of $21.00 per share.
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(
4)
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These restricted stock units, 19,977 of which were scheduled to vest on 2/16/2009 and 19,976 of which were scheduled to vest on 2/16/2010, were canceled pursuant to the terms of the Merger Agreement and the plan under which they were issued in exchange for a cash payment of $21.00 per share.
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(
5)
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These restricted stock units, 15,654 of which were scheduled to vest on 2/18/2009, 15,653 of which were scheduled to vest on 2/18/2010 and 15,653 of which were scheduled to vest on 12/31/2010, were canceled pursuant to the terms of the Merger Agreement and the plan under which they were issued in exchange for a cash payment of $21.00 per share.
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(
6)
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Pursuant to the terms of the Merger Agreement and the plan under which they were issued, upon consummation of the merger on October 28, 2008, these restricted stock purchase rights were canceled and converted into the right to receive cash in the amount of $21.00 per restricted stock purchase right, less any applicable exercise price per right.
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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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MASTROVICH LAWRENCE A
C/O APRIA HEALTHCARE GROUP INC.
26220 ENTERPRISE COURT
LAKE FOREST, CA 92630
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President and COO
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Signatures
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/s/ Lawrence A. Mastrovich by Raoul Smyth, Attorney-In-Fact
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10/28/2008
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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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