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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 | ||||||||
Option (Right to Buy) | $ 43.29 | 08/04/2016 | M | 2,251 | 01/15/2011(2) | 01/28/2020 | Common | 2,251 (2) | $ 0 (3) | 1,745 | D | ||||
Option (Right to Buy) | $ 49.17 | 08/04/2016 | M | 2,870 | 01/15/2012(4) | 01/27/2021 | Common | 2,870 (4) | $ 0 (3) | 2,338 | D | ||||
Option (Right to Buy) | $ 57.33 | 08/08/2016 | M | 13,303 | 01/15/2013(5) | 01/26/2022 | Common | 13,303 (5) | $ 0 (3) | 4,699 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Brinker Scott M 4500 DORR STREET TOLEDO, OH 43615 |
EVP - Chief Investment Officer |
By: Matthew McQueen Attorney-in-Fact For: Scott M. Brinker | 08/08/2016 | |
**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) | Scott M. Brinker Custodian, FBO Sevien G. Brinker, UTMA OH Until Age 21. |
(2) | Options for the purchase of 3,996 shares of common stock at $43.29 per share were granted to Mr. Brinker on January 28, 2010, which grant has previously been reported. Options for the purchase of 800 shares vested on January 15, 2011 and options for the purchase of 799 shares vested on January 15 of each of 2012, 2013, 2014 and 2015. |
(3) | The options were granted under the Welltower Inc. 2005 Long-Term Incentive Plan and had no acquisition price. |
(4) | Options for the purchase of 5,208 shares of common stock at $49.17 per share were granted to Mr. Brinker on January 27, 2011, which grant has previously been reported. Options for the purchase of 1,042 shares vested on January 15 of each of 2012, 2013 and 2014 and options for the purchase of 1,041 shares vested on January 15 of each of 2015 and 2016. |
(5) | Options for the purchase of 18,002 shares of common stock at $57.33 per share were granted to Mr. Brinker on January 26, 2012. Options for the purchase of 3,601 shares vested on January 15 of each of 2013 and 2014, options for the purchase of 3,600 shares vested on January 15 of each of 2015 and 2016, and options for the purchase of 3,600 shares will vest on January 15, 2017. |