Statement of Changes in Beneficial Ownership (4)
10 Januar 2022 - 11:41PM
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
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Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
*
Hagan Mark Christopher |
2. Issuer Name and Ticker or Trading Symbol
AMN HEALTHCARE SERVICES INC
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AMN
]
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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)
Chief Information and Digital |
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(Last)
(First)
(Middle)
12400 HIGH BLUFF DRIVE, SUITE 100 |
3. Date of Earliest Transaction
(MM/DD/YYYY)
1/6/2022 |
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(Street)
SAN DIEGO, CA 92130
(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 | 1/6/2022 | | M(1) | | 1166 | A | $0.00 | 11355 | D | |
| Common Stock | 1/6/2022 | | F(2) | | 541 | D | $118.61 | 10814 | D | |
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) | 2. Conversion or Exercise Price of Derivative Security | 3. Trans. Date | 3A. Deemed Execution Date, if any | 4. 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 Date | 7. 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) |
| Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
| Restricted Stock Units | (3) | 1/6/2022 | | M | | | 1166 | (4) | (5) | Common Stock | 1166 | $0.00 | 1203 | D | |
| Explanation of Responses: |
| (1) | Common Stock acquired on the vesting of Restricted Stock Units. |
| (2) | Number of shares withheld for tax purposes. |
| (3) | The Restricted Stock Units identified in this row were granted pursuant to the AMN Healthcare 2017 Equity Plan. Each Restricted Stock Unit represents a contingent right to receive one share of AMN Common Stock. |
| (4) | The Restricted Stock Units identified in this row were granted on January 6, 2020 and vest in three tranches on the first, second and third anniversaries of the grant date and the grantee's provision of three periods of credited service. |
| (5) | Restricted Stock Units do not have an expiration date. |
Reporting Owners
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| Reporting Owner Name / Address | Relationships |
| Director | 10% Owner | Officer | Other |
Hagan Mark Christopher
12400 HIGH BLUFF DRIVE, SUITE 100
SAN DIEGO, CA 92130 |
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| Chief Information and Digital |
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Signatures
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| /s/ Mark C. Hagan | | 1/10/2022 |
| **Signature of Reporting Person | Date |
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