SEC FORM 4/A SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

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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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
Hagan Mark Christopher

(Last) (First) (Middle)
12400 HIGH BLUFF DRIVE, SUITE 500

(Street)
SAN DIEGO CA 92130

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
AMN HEALTHCARE SERVICES INC [ AMN ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Chief Information and Digital
3. Date of Earliest Transaction (Month/Day/Year)
01/15/2023
4. If Amendment, Date of Original Filed (Month/Day/Year)
01/18/2023
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 01/15/2023 M(1) 1,332(2) A $0.00 25,354(2) D
Common Stock 01/15/2023 F(3) 461 D $103.86 24,893(2) D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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 Securities Underlying Derivative Security (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: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Restricted Stock Units (4) 01/15/2023 M 1,332 (5) (6) Common Stock 1,332 $0.00 2,706 D
Restricted Stock Units (4) 01/15/2023 A 4,212 (7) (6) Common Stock 4,212 $0.00 4,212 D
Explanation of Responses:
1. Common Stock acquired on the vesting of Restricted Stock Units.
2. This Form 4/A corrects an error in the total number of shares acquired upon the vesting of Restricted Stock Units, which was understated by 461 shares due to an administrative error. The same error occurred in the Reporting Person's Form 4s filed January 9, 2023 and January 6, 2023. The Form 4 filed on January 9, 2023 understated the Restricted Stock Units acquired by 416 shares, and the Form 4 filed on January 6, 2023 understated the Restricted Stock Units acquired by 880 shares and the Performance Restricted Stock Units acquired by 1,454 shares. The error flowed through to the reported amount of securities beneficially owned by the Reporting Person in the Form 4s filed February 17, 2023 and March 10, 2023. Following the transaction on March 9, 2023, the Reporting Person held 29,283 shares of common stock. The amount reported in Column 5 of Table 1 has been updated to reflect the number of shares of common stock held by the Reporting Person following the reported transaction.
3. Number of shares withheld for tax purposes.
4. The Restricted Stock Units identified in this row were granted pursuant to the AMN Healthcare 2017 Equity Plan. Each Restricted Stock Unit represents a contingent right to receive one share of AMN Common Stock.
5. The Restricted Stock Units identified in this row were granted on January 15, 2022 and vest in three tranches on each of the first, second and third anniversaries of the grant date and the grantee's provision of three periods of credited service.
6. Restricted Stock Units do not have an expiration date
7. The Restricted Stock Units identified in this row were granted on January 15, 2023 and vest in three tranches on each of the first, second and third anniversaries of the grant date and the grantee's provision of three periods of credited service.
Remarks:
Mark C. Hagan 03/30/2023
** 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 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).
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