Statement of Changes in Beneficial Ownership (4)
June 21 2021 - 5:26PM
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
|
OMB APPROVAL
OMB Number:
3235-0287
Estimated average burden hours per response...
0.5
|
|
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
*
Carnella Jonathan A. |
2. Issuer Name and Ticker or Trading Symbol
NorthStar Healthcare Income, Inc.
[
NONE
]
|
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director _____ 10% Owner _____ Officer (give title below) _____ Other (specify below)
|
(Last)
(First)
(Middle)
C/O NORTHSTAR HEALTHCARE INCOME, INC., 590 MADISON AVENUE, 34TH FLOOR |
3. Date of Earliest Transaction
(MM/DD/YYYY)
6/17/2021 |
(Street)
NEW YORK, NY 10022
(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 Stock | 6/17/2021 | | A(1)(2) | | 16710 | A | (3) | 33420 | 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 |
Explanation of Responses: |
(1) | Pursuant to the NorthStar Healthcare Income, Inc. (the "Company") Fourth Amended and Restated Independent Directors Compensation Plan (the "Plan"), each of the Company's independent directors receives a grant of $65,000 in restricted stock units ("Restricted Stock Units") convertible, on a one-for-one-basis, into common stock, par value $0.01, of the Company (the "Common Stock") following re-election to the Company's Board of Directors. |
(2) | The Restricted Stock Units vest quarterly over a two year period with an initial vesting date of July 1, 2021. Unless forfeited prior to the applicable vesting date, the Restricted Stock Units will be converted into shares of Common Stock on the earlier of (i) Change in Control (as defined in Section 409A of the Code) or (ii) the date of the director's "separation from service" (as defined in Section 409A of the Code). |
(3) | Pursuant to the Plan, the amount of Restricted Stock Units was determined by dividing the fixed grant value of $65,000 by the most recently disclosed net asset value of the Company's common stock, or $3.89. |
Reporting Owners
|
Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Carnella Jonathan A. C/O NORTHSTAR HEALTHCARE INCOME, INC. 590 MADISON AVENUE, 34TH FLOOR NEW YORK, NY 10022 | X |
|
|
|
Signatures
|
/s/ Ann B. Harrington, as Attorney-in-Fact | | 6/21/2021 |
**Signature of Reporting Person | Date |
NorthStar Healthcare Inc... (PK) (USOTC:NHHS)
Historical Stock Chart
From Sep 2024 to Oct 2024
NorthStar Healthcare Inc... (PK) (USOTC:NHHS)
Historical Stock Chart
From Oct 2023 to Oct 2024