AMERICAN SHARED HOSPITAL SERVICES — Director's Dealing 2021

Jun 7, 2021

SEC Form 4 — Statement of Changes in Beneficial Ownership

Issuer: AMERICAN SHARED HOSPITAL SERVICES (AMS)
CIK: 0000744825
Period of Report: 2020-05-04

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

Non-Derivative Transactions

Date	Security	Code	Shares	Price	A/D	Holdings After	Ownership
2020-05-04	Common stock	D	5883	—	Disposed	232178	Direct
2021-06-03	Common Stock No Par Value	M	2000	$2.43	Acquired	234178	Direct

Derivative Transactions

Date	Security	Exercise Price	Code	Shares	A/D	Expiration	Underlying	Ownership
2021-06-03	OPTION TO ACQUIRE	$2.43	M	2000	Disposed	2021-06-09	Common Stock No Par Value (2000.0)	Direct

Holdings (Non-Derivative)

Security	Shares	Ownership
Common Stock, No Par Value	57000	Indirect
Common Stock, No Par Value	760559	Indirect

Footnotes

F1: Mr. Stachowiak forfeited 5,883 Restricted STock Units in connections with his appointment as the Issuer's Interim President and Chief Executive Officer Effective May 4, 2020.