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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 | ||||||||
Restricted Stock Units (3) | $ 0.01 | 11/19/2007 | A(1) | 10,000 | 11/19/2007(1) | 11/12/2012 | Common Stock | 10,000 | $ 0 | 20,000 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
KARKENNY CHRIS A. C/O APRIA HEALTHCARE GROUP INC. 26220 ENTERPRISE COURT LAKE FOREST, CA 92630 |
Executive V. President & CFO |
\s\: Chris A. Karkenny by Raoul Smyth, Attorney-In-Fact | 11/21/2007 | |
**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) | Settlement and distribution of common stock from vested restricted stock units upon execution of Restricted Stock Unit Agreement granted under the issuer's 2003 Performance Incentive Plan. |
(2) | Election by employee to allow withholding by the issuer of 3,575 shares to satisfy withholding tax obligation for the issuance of 10,000 shares of common stock pursuant to Restricted Stock Unit Agreement awarded by the issuer on November 13, 2006. |
(3) | The restricted stock units were granted under the issuer's 2003 Performance Incentive Plan. This grant vests in three equal 10,000 share increments. The first increment vested as of November 13, 2007, following the Reporting Person's execution of the Restricted Stock Unit Award Agreement, and the remaining increments will vest on November 13, 2008 and November 13, 2009. |