- Statement of Changes in Beneficial Ownership (4)
May 27 2011 - 6:45PM
Edgar (US Regulatory)
FORM 4
[
X
]
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 Number:
3235-0287
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February 28, 2011
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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
*
Iannini Paul
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2. Issuer Name
and
Ticker or Trading Symbol
Emergency Medical Services CORP
[
EMS
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__
X
__ Director
_____ 10% Owner
_____ Officer (give title below)
_____ Other (specify below)
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(Last)
(First)
(Middle)
195 LAKE PLACE SOUTH
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3. Date of Earliest Transaction
(MM/DD/YYYY)
5/25/2011
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(Street)
DANBURY, CT 06810
(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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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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Restricted Stock Units
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(1)
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5/25/2011
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D
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8000
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(2)
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(2)
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Class A Common Stock
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8000
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(2)
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0
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D
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Restricted Stock Units
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(1)
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5/25/2011
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D
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2705
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(2)
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(2)
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Class A Common Stock
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2705
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(2)
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0
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D
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Restricted Stock Units
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(1)
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5/25/2011
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D
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4145
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(2)
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(2)
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Class A Common Stock
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4145
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(2)
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0
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D
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Restricted Stock Units
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(1)
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5/25/2011
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D
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3018
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(2)
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(2)
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Class A Common Stock
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3018
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(2)
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0
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D
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Restricted Stock Units
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(1)
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5/25/2011
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D
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2325
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(2)
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(2)
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Class A Common Stock
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2325
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(2)
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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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Each Restricted Stock Unit represents the right to receive one share of the issuer's Class A Common Stock.
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(
2)
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Pursuant to the merger agreement dated as of February 13, 2011, by and among the issuer, CDRT Acquisition Corporation and CDRT Merger Sub, Inc., the Restricted Stock Units became vested in full at the effective time of the merger (to the extent not previously vested) and were cancelled in exchange for a cash payment equal to $64.00 times the number of shares of Class A Common Stock subject to such Restricted Stock Units.
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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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Iannini Paul
195 LAKE PLACE SOUTH
DANBURY, CT 06810
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X
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Signatures
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/s/ Carl F. Berglind, as attorney-in-fact
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5/26/2011
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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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