Statement of Changes in Beneficial Ownership (4)
21 Décembre 2021 - 12:22AM
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
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3235-0287
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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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1. Name and Address of Reporting Person
*
SALKA SUSAN R |
2. Issuer Name and Ticker or Trading Symbol
AMN HEALTHCARE SERVICES INC
[
AMN
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director _____ 10% Owner __X__ Officer (give title below) _____ Other (specify below) Chief Executive Officer |
(Last)
(First)
(Middle)
8840 CYPRESS WATERS BLVD., SUITE 300 |
3. Date of Earliest Transaction
(MM/DD/YYYY)
12/16/2021 |
(Street)
COPPELL, TX 75019
(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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Common Stock | 12/16/2021 | | M(1) | | 6476 | A | $0.00 | 31473 | D | |
Common Stock | 12/16/2021 | | F(2) | | 2549 | D | $114.39 | 28924 | D | |
Common Stock | 12/16/2021 | | M(1) | | 6849 | A | $0.00 | 35773 | D | |
Common Stock | 12/16/2021 | | F(2) | | 2696 | D | $114.39 | 33077 | D | |
Common Stock | 12/17/2021 | | M(1) | | 7543 | A | $0.00 | 40620 | D | |
Common Stock | 12/17/2021 | | F(2) | | 2969 | D | $113.73 | 37651 (3) | D | |
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) | 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 |
Restricted Stock Units | (4) | 12/16/2021 | | M | | 6476 | | (5) | (6) | Common Stock | 6476 | $0.00 | 13149 | D | |
Restricted Stock Units | (4) | 12/16/2021 | | M | | 6849 | | (7) | (6) | Common Stock | 6849 | $0.00 | 7057 | D | |
Restricted Stock Units | (4) | 12/17/2021 | | M | | 7543 | | (8) | (6) | Common Stock | 7543 | $0.00 | 0 | D | |
Explanation of Responses: |
(1) | Common Stock acquired on the vesting of Restricted Stock Units (RSUs). |
(2) | Number of shares withheld for tax purposes. |
(3) | The number of shares reflected in this column does not include 101,243 vested RSUs that the Reporting Person elected to defer at the time of grant until her separation from service with the Company. |
(4) | The RSUs reflected in this row were granted pursuant to the AMN Healthcare 2017 Equity Plan. Each Restricted Stock Unit represents a contingent right to receive one share of AMN Common Stock. |
(5) | The RSUs reflected in this row were granted on December 16, 2020 and vest on the first, second and third anniversary of the grant date. |
(6) | RSUs do not have an expiration date. |
(7) | The RSUs reflected in this row were granted on December 16, 2019 and vest on the first, second and third anniversary of the grant date. |
(8) | The RSUs reflected in this row were granted on December 17, 2018 and vest on the first, second and third anniversary of the grant date. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
SALKA SUSAN R 8840 CYPRESS WATERS BLVD., SUITE 300 COPPELL, TX 75019 | X |
| Chief Executive Officer |
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Signatures
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/s/ Susan R. Salka | | 12/20/2021 |
**Signature of Reporting Person | Date |
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