Sec Form 13D Filing - Stachowiak Raymond C filing for American Shared Hospital Services (AMS) - 2025-01-03

Insider filing report for Changes in Beneficial Ownership

  • Schedule 13G & 13D forms are used to report a party's ownership of stock which exceeds 5% of a company's total stock issue.
  • Schedule 13G is a shorter version of Schedule 13D with fewer reporting requirements.
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If the filing person has previously filed a statement on Schedule 13G to report the acquisition that is the subject of this Schedule 13D, and is filing this schedule because of §§ 240.13d-1(e), 240.13d-1(f) or 240.13d-1(g), check the following box. Checkbox not checked

The information required on the remainder of this cover page shall not be deemed to be “filed” for the purpose of Section 18 of the Securities Exchange Act of 1934 (“Act”) or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however, see the Notes).






SCHEDULE 13D



Comment for Type of Reporting Person:
(1)Includes 74,678 shares of common stock, no par value (the "Common Stock") of American Shares Hospital Services (the "Issuer") that are issuable to Mr. Stachowiak upon the exercise of stock options and vesting of restricted stock units within 60 days of January 3, 2025, the filing date of this Schedule 13D/A (the "Filing Date").(2)Includes 158,500 shares of Common Stock owned by RCS Investments, Inc. ("RCS"), of which Mr. Stachowiak is the president. RCS is wholly owned by the Raymond C Stachowiak Revocable Trust dated November 19, 1998 (the "Stachowiak Trust"), of which Mr. Stachowiak is the sole trustee and, in such capacity, may direct the voting and investment of the securities held by RCS. In his capacity as owner-president of RCS, Mr. Stachowiak may be deemed to have or share beneficial ownership of the shares of Common Stock held of record by RCS.(3)Includes 760,559 shares of Common Stock owned by Stachowiak Equity Fund, LLC (Stachowiak Equity"), of which Mr. Stachowiak is the manager. Stachowiak Equity is owned 60% by the Stachowiak Trust, of which Mr. Stachowiak is the sole trustee, and 20% by each of two trusts established for Mr. Stachowiak's children, of which Mr. Stachowiak's spouse is the sole trustee. In his capacity as owner-manager of Stachowiak Equity, Mr. Stachowiak may be deemed to have or share beneficial ownersh ip of the shares of Common Stock held of record by Stachowiak Equity.(4)This percentage was calculated in accordance with the U.S. Securities and Exchange Commission (the "SEC") rules for calculating percentages of beneficial ownership, based on the Issuer having an aggregate of 6,420,000 shares of Common Stock issued and outstanding as of November 8, 2024, as reported by the Issuer in its Quarterly Report on Form 10-Q filed with the SEC on November 14, 2024 (the "Quarterly Report") and includes 74,678 Common Shares that Mr. Stachowiak has the right to acquire within 60 days of January 3, 2025 upon the exercise of stock options and vesting of restricted stock units


SCHEDULE 13D



Comment for Type of Reporting Person:
(1)This percentage is based on the Issuer having an aggregate of 6,420,000 shares of Common Stock issued and outstanding as of November 8, 2024, as reported in the Issuer's Quarterly Report.


SCHEDULE 13D



Comment for Type of Reporting Person:
(1)This percentage is based on the Issuer having an aggregate of 6,420,000 shares of Common Stock issued and outstanding as of November 8, 2024, as reported in the Issuer's Quarterly Report.


SCHEDULE 13D

 
Stachowiak Raymond C
 
Signature:/s/ Raymond C. Stachowiak
Name/Title:Individual
Date:01/03/2025
 
RCS Investments, Inc.
 
Signature:/s/ Raymond C. Stachowiak
Name/Title:President
Date:01/03/2025
 
Stachowiak Equity Fund, LLC
 
Signature:/s/ Raymond C. Stachowiak
Name/Title:Manager
Date:01/03/2025
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