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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 Restricted Stock Units | (3) | 01/02/2019 | M | 42,096 | (4) | (5) | Common Stock | 42,096 | $ 0 | 0 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
SALKA SUSAN R 8840 CYPRESS WATERS BLVD., SUITE 300 COPPELL, TX 75019 |
X | President and CEO |
/s/ Susan R. Salka | 01/04/2019 | |
**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 acquisition of AMN Common Stock set forth in this row resulted from the deferred release of a Performance Restricted Stock Unit ("PRSU") award that vested on January 4, 2017. In 2014, the reporting person elected to defer receipt of these PRSUs pursuant to the Company's deferred compensation plan, with a settlement date of January 2, 2019. |
(2) | Number of shares withheld for tax purposes. |
(3) | The PRSUs set forth in this row were granted pursuant to the AMN Healthcare Equity Plan. Each PRSU represents a contingent right to receive one share of AMN Common Stock. |
(4) | The PRSUs set forth in this row resulted from the vesting of a PRSU award granted by the Company on January 3, 2014. On January 4, 2017, the maximum number of PRSUs that could have been earned, 42,096, were deemed earned and vested under this January 3, 2014 PRSU award. |
(5) | PRSUs do not have an expiration date. |