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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 | ||||||||
Deferred Stock Units | $ 0 (4) | 11/01/2012 | M | 3,270 | 11/01/2012(4) | 11/01/2012 | Common | 3,270 (4) | $ 0 (4) | 0 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Loftus Daniel R 4500 DORR STREET TOLEDO, OH 43615 |
Senior Vice President |
By: Erin C. Ibele Attorney-in-Fact For: Daniel R. Loftus | 11/02/2012 | |
**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) | Tax withholding in shares of common stock on 926 shares of common stock granted on January 21, 2008, 2,204 shares of common stock granted on January 29, 2009, 2,547 shares of common stock granted on January 28, 2010, 3,080 shares of common stock granted on January 27, 2011 and 4,449 shares of common stock granted on January 26, 2012, which grants vested on November 1, 2012. |
(2) | In connection with Mr. Loftus' termination of employment on November 1, 2012, the reported transaction was a vesting of 3,270 deferred stock units on November 1, 2012, resulting in the issuance of 3,270 shares of common stock. No amount was payable in connection with the vesting or the common stock issuance. 339 performance shares were forfeited in connection with Mr. Loftus' termination of employment on November 1, 2012. The performance shares are neither equity securities nor derivative securities as defined by the Commission for purposes of this form and, accordingly, are not reported separately herein. |
(3) | Tax withholding in shares of common stock on 3,270 deferred stock units granted on January 26, 2012, which grant vested on November 1, 2012. |
(4) | These deferred stock units were granted without cash consideration on January 26, 2012 under the Amended and Restated Health Care REIT, Inc. 2005 Long-Term Incentive Plan. In connection with Mr. Loftus' termination of employment on November 1, 2012, (i) 3,270 deferred stock units vested on November 1, 2012 and (ii) 25,834 stock options vested on November 1, 2012. All vested options are exercisable by Mr. Loftus until November 1, 2013. |