FORM 3 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
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1. Name and Address of Reporting Person*
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 08/07/2016 |
3. Issuer Name and Ticker or Trading Symbol
MEDNAX, INC. [ MD ] |
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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5. If Amendment, Date of Original Filed
(Month/Day/Year) |
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6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Beneficially Owned | |||
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1. Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
Common Stock | 28,304(1)(2) | D |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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1. Title of Derivative Security (Instr. 4) | 2. Date Exercisable and Expiration Date (Month/Day/Year) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 6. Nature of Indirect Beneficial Ownership (Instr. 5) | ||
Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
Stock Options (Right to Buy) | 06/01/2010 | 06/01/2017 | Common Stock | 2,500(3) | 28.545 | D | |
Stock Options (Right to Buy) | 06/01/2011 | 06/02/2018 | Common Stock | 12,000(4) | 27.715 | D |
Explanation of Responses: |
1. Includes 1,121 restricted shares granted pursuant to Issuer's 2008 Amended and Restated Incentive Compensation Plan, as amended ("ICP") which will vest on June 1, 2017. Also includes 1,840 restricted shares granted pursuant to Issuer's ICP which will vest in equal installments on June 1, 2017 and June 1, 2018. Also includes 3,310 restricted shares granted pursuant to Issuer's ICP which will vest in three installments on June 1, 2017, June 1, 2018 and June 1, 2019. |
2. Includes 13,111 shares directly owned by Reporting Person and 8,922 shares that were acquired by Reporting Person through Issuer's Employee Stock Purchase Plan. |
3. Stock Options granted under Issuer's 2004 Incentive Compensation Plan. |
4. Stock Options granted under Issuer's 2008 Incentive Compensation Plan. |
Remarks: |
Dominic J. Andreano, Attorney-in-Fact | 08/12/2016 | |
** Signature of Reporting Person | Date | |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | ||
* If the form is filed by more than one reporting person, see Instruction 5 (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). | ||
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
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 Number. |