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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 | ||||||||
Stock Option | $ 6.67 | 07/29/2006(1) | 07/29/2015 | Class A Common Stock | 3,750 | 3,750 | D | ||||||||
Restricted Stock Unit | (2) | 06/01/2006(3) | A | 8,000 | (4) | (4) | Class A Common Stock | 8,000 | $ 0 | 8,000 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
KELLY JAMES TIMOTHY 64 BOGGS HILL ROAD NEWTOWN, CT 06470 |
X |
/s/ James T. Kelly, Director of Emergency Medical Services Corporation | 06/12/2006 | |
**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) | The options vest ratably on the first four anniversaries of the grant date, beginning July 29, 2006, provided that the exercisability of one-half of the options is conditioned upon meeting certain specified performance targets. |
(2) | Each Restricted Stock Unit represents the right to receive one share of the Issuer's class A common stock. |
(3) | The Restricted Stock Units were granted to the Reporting Person by the Issuer's Board of Directors on June 1, 2006, subject to stockholder approval at the 2007 annual meeting of stockholders. As such, the grant date may be deemed to be the date of the Issuer's 2007 annual meeting of stockholders. |
(4) | The Restricted Stock Units vest on June 1, 2007, subject to receipt of stockholder approval. |