Statement of Changes in Beneficial Ownership (4)
May 10 2022 - 06:56PM
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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OMB
APPROVAL
OMB Number: 3235-0287
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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
|
|
1. Name
and Address of Reporting Person *
Fitzgerald Trae |
2. Issuer Name and Ticker or Trading
Symbol VIEMED HEALTHCARE, INC. [ VMD ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)_____
Director _____
10% Owner
__X__ Officer (give title
below) _____ Other
(specify below)
Chief Financial Officer |
(Last)
(First)
(Middle)
625 E. KALISTE SALOOM RD. |
3. Date of Earliest Transaction (MM/DD/YYYY)
5/9/2022
|
(Street)
LAFAYETTE, LA 70508
(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 Shares |
5/9/2022 |
|
M |
|
1337 |
A |
(1) |
54638 |
D |
|
Common Shares |
5/9/2022 |
|
D |
|
1337 |
D |
$5.26 |
53301 |
D |
|
Common Shares |
5/9/2022 |
|
M |
|
1087 |
A |
(1) |
54388 |
D |
|
Common Shares |
5/9/2022 |
|
D |
|
1087 |
D |
$5.26 |
53301 |
D |
|
Common Shares |
5/9/2022 |
|
M |
|
1158 |
A |
(1) |
54459 |
D |
|
Common Shares |
5/9/2022 |
|
D |
|
1158 |
D |
$5.26 |
53301 |
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
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 |
Phantom Share Units |
(2) |
5/9/2022 |
|
M |
|
|
1337 |
(3) |
5/9/2022 |
Common Shares |
1337.0 |
$0 |
0 |
D |
|
Phantom Share Units |
(2) |
5/9/2022 |
|
M |
|
|
1087 |
(4) |
5/9/2023 |
Common Shares |
1087.0 |
$0 |
1087 |
D |
|
Phantom Share Units |
(2) |
5/9/2022 |
|
M |
|
|
1158 |
(5) |
5/9/2024 |
Common Shares |
1158.0 |
$0 |
2314 |
D |
|
Explanation of
Responses: |
(1) |
Represents vesting of
cash-settled phantom shares granted under the Issuer's Phantom
Share Unit Plan. Each phantom share is the economic equivalent of
one share of the Company's common shares. The settlement of the
phantom shares for cash is reported on this Form 4 as a disposition
of the phantom shares being settled in exchange for the acquisition
of the underlying Company common shares, and a simultaneous
disposition of the underlying Company common shares to the Company
for cash. |
(2) |
Each share of phantom stock
represents a right to receive the cash value of one share of the
Issuer's common shares which will be determined based on the
Issuer's share price on the vesting date. |
(3) |
Represents an award granted
in 2019 under the Issuer's Phantom Share Unit Plan which vests on
May 9, 2022, subject to the Reporting Person's continued employment
with the Issuer on such vesting date. |
(4) |
Represents an award granted
in 2020 under the Issuer's Phantom Share Unit Plan which vests in
equal installments on May 9, 2022 and May 9, 2023, subject to the
Reporting Person's continued employment with the Issuer on such
vesting date. |
(5) |
Represents an award granted
in 2021 under the Issuer's Phantom Share Unit Plan which vests in
equal installments on May 9, 2022, May 9, 2023, and May 9, 2024,
subject to the Reporting Person's continued employment with the
Issuer on such vesting date. |
Reporting
Owners
|
Reporting Owner Name / Address |
Relationships
|
Director |
10% Owner |
Officer |
Other |
Fitzgerald Trae
625 E. KALISTE SALOOM RD.
LAFAYETTE, LA 70508 |
|
|
Chief Financial Officer |
|
Signatures
|
/s/ Trae Fitzgerald |
|
5/10/2022 |
**Signature of
Reporting Person |
Date |
Reminder: Report on a separate line for each class
of securities beneficially owned directly or
indirectly. |
* |
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). |
Note: |
File three copies of this Form, one of
which must be manually signed. If space is insufficient, see
Instruction 6 for procedure. |
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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