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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES 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(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
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. | SEC 1474 (9-02) |
1. Title of Derivative Security (Instr. 3) |
2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction 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 (Month/Day/Year) |
7. Title and Amount of Underlying Securities (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) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Restricted Stock | (1) | 06/10/2015 | A | 246 | (2) | (2) | Common stock | 246 | $ 0 | 33,216 (3) | D | ||||
Restricted Stock | (1) | 06/10/2015 | A | 924 | (4) | (4) | Common stock | 924 | $ 0 | 124,777 (3) | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Smith Layle Kiplind 801 CRESCENT CENTRE DRIVE SUITE 600 FRANKLIN, TN 37067 |
X | President and CEO |
/s/ Gail E. Lehman, Attorney-in-Fact for Layle K. Smith | 10/01/2015 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 4(b)(v). |
** | Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
(1) | Each share of restricted stock is the economic equivalent of one share of Issuer common stock. |
(2) | This report relates to shares of restricted stock awarded in the form of dividend equivalents on unvested underlying shares of restricted stock awarded on April 12, 2013, and on unvested underlying shares of restricted stock previously awarded as dividend equivalents thereon. Subsequent to the grant date, these shares of restricted stock will vest at the same times, and in the same proportions, as the previously awarded shares of restricted stock to which they relate. The outstanding shares of restricted stock will vest on April 12, 2016. |
(3) | This amendment is being filed solely to correct the number of shares of restricted stock held by the reporting person following the reported transactions. The number of shares shown does not reflect the one-for-seven stock split (the "Reverse Stock Split") of the issuer's common stock that occurred on August 25, 2015. The effect of the Reverse Stock Split will be reflected on the reporting person's Forms 4 that report transactions occurring subsequent to August 25, 2015. |
(4) | This report relates to shares of restricted stock awarded in the form of dividend equivalents on unvested underlying shares of restricted stock awarded on May 2, 2014, and on unvested underlying shares of restricted stock previously awarded as dividend equivalents thereon. Subsequent to the grant date, these shares of restricted stock will vest at the same times, and in the same proportions, as the previously awarded shares of restricted stock to which they relate. One-third of the outstanding shares of restricted stock will vest on May 2, 2015, and the remaining two-thirds will vest on May 2, 2016. |