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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 |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Bond David A 5501 DILLARD DRIVE CARY, NC 27511 |
President, SMB Solutions |
Jena Kluska for David A. Bond by Power of Attorney | 11/13/2006 | |
**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) | Amount of securities beneficially owned includes 20,000 shares of unvested restricted stock, granted under the Allscripts Healthcare Solutions, Inc. 1993 Stock Incentive Plan. |
(2) | Amount of securities beneficially owned includes 24,015 shares which were issued to LaSalle Bank National Association, as escrow agent, pursuant to the Escrow Agreement, dated as of March 2, 2006, by and among the issuer, John P. McConnell, as representative of the shareholders (the "Representative"), and the escrow agent (the "Escrow Agreement"). The 24,015 shares are being held in escrow, subject to forfeiture for a period of time following the merger, to indemnify, hold harmless and reimburse the issuer, among others, for certain losses and expenses as specified in the Agreement of Merger, dated as of January 18, 2006 by and among the issuer, Quattro Merger Sub Corp., A4 Health Systems, Inc. and the Representative. |