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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 | ||||||||
Non-Qualified Stock Option (right to buy) | $ 17.33 | 02/25/2015 | A | 15,625 | 02/25/2015 | 11/02/2021 | Common Stock | 15,625 | $ 0 | 15,625 (1) | D | ||||
Stock Appreciation Right | $ 22.95 | 02/25/2015 | A | 31,250 | 02/25/2015 | 02/08/2022 | Common Stock | 31,250 | $ 0 | 31,250 (2) | D | ||||
Stock Appreciation Right | $ 37.18 | 02/25/2015 | A | 23,750 | 02/25/2015 | 02/06/2023 | Common Stock | 23,750 | $ 0 | 23,750 (3) | D | ||||
Stock Appreciation Right | $ 47.97 | 02/25/2015 | A | 20,625 | 02/25/2015 | 02/05/2024 | Common Stock | 20,625 | $ 0 | 20,625 (4) | D | ||||
Restricted Stock Units | (5) | 02/25/2015 | A | 4,783 | (6) | (6) | Common Stock | 4,783 | $ 0 | 4,783 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
HAZEN SAMUEL N ONE PARK PLAZA NASHVILLE, TN 37203 |
COO |
/s/ Natalie Harrison Cline, Attorney-in-Fact | 02/27/2015 | |
**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) | On November 2, 2011, the reporting person was granted an option to purchase 62,500 shares of common stock. The option vests in equal increments of up to 25% at the end of each of fiscal years 2011, 2012, 2013 and 2014 based upon the extent to which certain EBITDA performance targets have been met for the applicable fiscal year. Based upon the Company's achievement with respect to the EBITDA performance criteria for 2014, 100% of the shares subject to such criteria vested, resulting in the vesting of the option as to 15,625 shares. |
(2) | On February 8, 2012, the reporting person was granted 125,000 stock appreciation rights. The stock appreciation rights are eligible to vest in equal increments of up to 25% at the end of fiscal years 2012, 2013, 2014 and 2015 based upon the extent to which certain EBITDA performance targets have been met for the applicable fiscal year. Based upon the Company's achievement with respect to the EBITDA performance criteria for 2014, 100% of the stock appreciation rights subject to such criteria vested, resulting in the vesting of 31,250 stock appreciation rights. |
(3) | On February 6, 2013, the reporting person was granted 95,000 stock appreciation rights. The stock appreciation rights are eligible to vest in equal increments of up to 25% at the end of fiscal years 2013, 2014, 2015 and 2016 based upon the extent to which certain EBITDA performance targets have been met for the applicable fiscal year. Based upon the Company's achievement with respect to the EBITDA performance criteria for 2014, 100% of the stock appreciation rights subject to such criteria vested, resulting in the vesting of 23,750 stock appreciation rights. |
(4) | On February 5, 2014, the reporting person was granted 82,500 stock appreciation rights. The stock appreciation rights are eligible to vest in equal increments of up to 25% at the end of fiscal years 2014, 2015, 2016 and 2017 based upon the extent to which certain EBITDA performance targets have been met for the applicable fiscal year. Based upon the Company's achievement with respect to the EBITDA performance criteria for 2014, 100% of the stock appreciation rights subject to such criteria vested, resulting in the vesting of 20,625 stock appreciation rights. |
(5) | Each restricted stock unit represents a contingent right to receive one share of HCA Holdings, Inc. common stock. |
(6) | The restricted stock units vest in two equal installments on the second and third anniversaries of the grant date. |