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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 | ||||||||
Performance-Based Restricted Shares (2) | (2) | 03/31/2015 | A | 75,000 (2) | (2) | (2) | Common Stock | (2) | $ 0 | 75,000 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Kusserow Paul B. K. AMEDISYS, INC. 5959 S. SHERWOOD FOREST BLVD. BATON ROUGE, LA 70816 |
X | CEO and President |
/S/ Celeste R. Peiffer on behalf of Paul B. Kusserow pursuant to a power of attorney. | 04/02/2015 | |
**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) | The shares reported are subject to service-based vesting conditions as follows: 25% of the total shares awarded will vest on December 16, 2015, 25% of the total shares awarded will vest on December 16, 2016, 25% of the total shares awarded will vest on December 16, 2017 and and 25% of the total shares awarded will vest on December 16, 2018, provided that the Reporting Person remains continuously employed by the Issuer through each such date. |
(2) | Each performance-based restricted share represents a contingent right to receive one share of of unrestricted common stock. The performance-based restricted shares shall vest, if at all, based on the certification by the Comensation Committee of the Issuer's Board of Directors of the achievement of identified performance goals for fiscal years 2015 through 2018, respectively (subject to certain pro-rated vesting provisions as provided in the award agreement for the performance-based restricted shares). The number of performance-based restricted shares listed in Table II, Column 5 represents the maximum number of shares of unrestricted common stock the Reporting Person would receive based on the satisfaction of all of the pre-determined performance goals. |