4: Statement of changes in beneficial ownership of securities
Published on April 3, 2015
FORM 4 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). |
1. Name and Address of Reporting Person*
(Street)
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2. Issuer Name and Ticker or Trading Symbol
OMEGA HEALTHCARE INVESTORS INC [ OHI ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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3. Date of Earliest Transaction
(Month/Day/Year) 04/01/2015 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed
(Month/Day/Year) |
6. Individual or Joint/Group Filing (Check Applicable Line)
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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) | 2. Transaction Date (Month/Day/Year) | 2A. Deemed Execution Date, if any (Month/Day/Year) | 3. Transaction 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 | 04/01/2015 | A | 153,757(1) | A | $40.57 | 153,757 | D | |||
Common Stock | 04/01/2015 | A | 53,872(2) | A | $40.57 | 207,629 | D | |||
Common Stock | 04/01/2015 | F | 23,707(3) | D | $40.57 | 183,922 | D |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||||||||||
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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 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: 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 | ||||||||
Stock Options (Right to Buy) | $18.41 | 04/01/2015 | A | 796,900(4) | 04/01/2015 | (5) | Common Stock | 796,900 | $0 | 796,900 | D | ||||
Stock Options (Right to Buy) | $19.96 | 04/01/2015 | A | 17,712(4) | 04/01/2015 | (5) | Common Stock | 17,712 | $0 | 17,712 | D | ||||
Stock Options (Right to Buy) | $20.7 | 04/01/2015 | A | 16,950(4) | 04/01/2015 | (5) | Common Stock | 16,950 | $20.7 | 16,950 | D | ||||
Stock Options (Right to Buy) | $20.97 | 04/01/2015 | A | 181,306(4) | 04/01/2015 | (5) | Common Stock | 181,306 | $0 | 181,306 | D | ||||
Stock Options (Right to Buy) | $20.73 | 04/01/2015 | A | 137,242(4) | 04/01/2015 | (5) | Common Stock | 137,242 | $0 | 137,242 | D | ||||
Restricted Stock Units | (6) | 04/01/2015 | A | 4,274(7) | (8) | (8) | Common Stock | 4,274 | $40.57 | 4,274 | D | ||||
Restricted Stock Units | (6) | 04/01/2015 | A | 6,696(9) | (10) | (10) | Common Stock | 6,696 | $40.57 | 10,970 | D | ||||
Restricted Stock Units | (11) | 04/01/2015 | A | 24,914 | (11) | (11) | Common Stock | 24,914 | $40.57 | 35,884 | D |
Explanation of Responses: |
1. Received in exchange for 170,844 shares (including restricted shares) of common stock of Aviv REIT, Inc. ("Aviv") in connection with the merger of Aviv REIT, Inc. into a wholly owned subsidiary of the Issuer (the "Merger"). |
2. Received in exchange for 59,860 performance-based restricted stock units of Aviv. |
3. Represents stock withheld as payment of income tax liability in connection with the delivery of shares subject to performance-based restricted stock units of Aviv. |
4. Received in the Merger in exchange for an employee stock option to acquire shares of Aviv common stock. |
5. Does not expire |
6. Each restricted stock unit ("RSU") represents a contingent right to receive one share of common stock of the Issuer. |
7. Received in the Merger in exchange for 4,749 RSUs of Aviv. |
8. The RSUs vest on December 31, 2015, subject in each case to the holder not incurring a termination through the vesting date. |
9. Received in the Merger in exchange for 7,441 RSUs of Aviv. |
10. The RSUs vest on December 31, 2016, subject in each case to the holder not incurring a termination through the vesting date. |
11. Represents grant of RSUs subject to cliff vesting on December 31, 2017 and subject to continued employment on the vesting date and certain exceptions for qualifying termination of employment. |
/s/ Thomas H. Peterson, Attorney-in-Fact | 04/03/2015 | |
** 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 Number. |