AMERICAN SHARED HOSPITAL SERVICES — Director's Dealing 2017

Jan 5, 2017

SEC Form 4 — Statement of Changes in Beneficial Ownership

Issuer: AMERICAN SHARED HOSPITAL SERVICES (AMS)
CIK: 0000744825
Period of Report: 2017-01-03

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

Non-Derivative Transactions

Date	Security	Code	Shares	Price	A/D	Holdings After	Ownership
2017-01-03	Common Stock, No Par Value	A	5883	—	Acquired	53209	Direct

Holdings (Non-Derivative)

Security	Shares	Ownership
Common Stock, No Par Value	56500	Indirect
Common Stock, No Par Value	600000	Indirect

Footnotes

F1: Deferred restricted stock units vesting equally over four (4) successive quarters from the transaction date, but not issued until termination of the reporting person's service to the issuer.

F2: The totals have been corrected from the amounts in the previous Form 4 to correct mathematical errors (including double-counting of 500 shares) in previous filings. The corrections resulted in an increase in total indirect holdings by 1,000 shares and a decrease in total direct holdings by 1,500 shares.

F3: 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.