AMERICAN SHARED HOSPITAL SERVICES — Director's Dealing 2016

Nov 17, 2016

SEC Form 4 — Statement of Changes in Beneficial Ownership

Issuer: AMERICAN SHARED HOSPITAL SERVICES (AMS)
CIK: 0000744825
Period of Report: 2016-11-15

Reporting Person: Stachowiak Raymond C (Director, 10% Owner)

Non-Derivative Transactions

Date	Security	Code	Shares	Price	A/D	Holdings After	Ownership
2016-11-15	Common Stock, No Par Value	M	100000	$2.20	Acquired	255500	Indirect
2016-11-15	Common Stock, No Par Value	G	200000	$0.00	Disposed	55500	Indirect
2016-11-15	Common Stock, No Par Value	G	200000	$0.00	Acquired	600000	Indirect

Derivative Transactions

Date	Security	Exercise Price	Code	Shares	A/D	Expiration	Underlying	Ownership
2016-11-15	Warrants (right to purchase)	$2.20	M	100000	Disposed	2017-10-22	Common Stock (100000)	Indirect

Holdings (Non-Derivative)

Security	Shares	Ownership
Common Stock, No Par Value	48826	Direct

Footnotes

F1: Fund is 60% controlled by a trust with the reporting person as sole trustee and beneficiary, and 20% each by two trusts established for the benefit of the reporting person's children, with the spouse of the reporting person as sole trustee of each.