- Statement of Changes in Beneficial Ownership (4)
February 23 2011 - 4:36PM
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).
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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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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
*
HART JOHN P
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2. Issuer Name
and
Ticker or Trading Symbol
NOVAMED INC
[
NOVA
]
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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)
VP, Corporate Controller
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(Last)
(First)
(Middle)
333 W. WACKER DR., SUITE 1010
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3. Date of Earliest Transaction
(MM/DD/YYYY)
2/21/2011
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(Street)
CHICAGO, IL 60606
(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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2/21/2011
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F
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44
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D
(8)
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$13.21
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12263
(5)
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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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Stock Option (right to buy)
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$6.12
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(1)
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9/29/2013
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Common Stock
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20000
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8334
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D
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Stock Option (right to buy)
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$13.35
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(2)
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3/17/2014
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Common Stock
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8333
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0
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D
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Stock Option (right to buy)
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$17.88
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(3)
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6/17/2015
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Common Stock
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10000
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0
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D
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Stock Option (right to buy)
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$20.61
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(4)
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6/20/2016
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Common Stock
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5833
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0
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D
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Stock Option (right to buy)
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$22.05
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(6)
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2/21/2017
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Common Stock
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5833
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0
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D
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Stock Option (right to buy)
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$8.25
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(7)
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2/18/2019
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Common Stock
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9091
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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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As of 9/29/2007, these options have all fully vested.
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(
2)
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As of 3/17/2008, these options have all fully vested.
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(
3)
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As of 6/17/2009, these options have all fully vested.
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(
4)
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As of 6/20/2010, these options have all fully vested.
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(
5)
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Includes 6,957 restricted shares of common stock. This share total and the other share figures reported on this Form 4 have been adjusted to reflect the Issuer's one-for-three reverse stock split which was effective on June 1, 2010.
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(
6)
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Subject to certain restrictions, 729 of these options vested on 8/21/07 with the remainder vesting approximately 121 per month starting on 9/21/07.
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(
7)
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Subject to certain restrictions, 1,136 of these options vested on 8/18/09 with the remainder vesting approximately 189 per month starting on 9/18/09.
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(
8)
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Represents the disposition of shares to the Issuer to fund the Reporting Person's tax withholding obligations relating to the vesting on 2/21/2011 of 122 shares of a restricted stock award as permitted pursuant to the terms of the award.
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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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HART JOHN P
333 W. WACKER DR.
SUITE 1010
CHICAGO, IL 60606
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VP, Corporate Controller
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Signatures
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/s/ JOHN P. HART
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2/23/2011
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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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