13D Filing: Park City Capital, Llc and Adcare Health Systems Inc (NYSEMKT:ADK)

Page 6 of 9 – SEC Filing

 

CUSIP No. 000650W300 13D/A

Page 6 of 9 Pages

 


1

NAME OF REPORTING PERSON


MICHAEL J. FOX

2

CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP

 

(a) ¨
(b) ¨
3

SEC USE ONLY

4

SOURCE OF FUNDS

PF; OO

5

CHECK IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT
TO ITEM 2(d) or 2(e)

¨
6

CITIZENSHIP OR PLACE OF ORGANIZATION


USA

NUMBER OF SHARES BENEFICIALLY OWNED BY EACH REPORTING PERSON WITH   7 SOLE VOTING                                             134,274*
  8

SHARED VOTING POWER                       1,078,418**

 

  9 SOLE DISPOSITIVE POWER                     134,274*
 10 SHARED DISPOSITIVE POWER              1,078,418**
11

AGGREGATE AMOUNT BENEFICIALLY OWNED BY REPORTING PERSON

1,212,692**

12

CHECK IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN SHARES

 

¨
13

PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11)

 

6.1%

14

TYPE OF REPORTING PERSON

IN

____________

*Includes 12,077 shares of Common Stock
held directly by Mr. Fox, 73,532 options to purchase shares of Common Stock and 48,665 restricted shares.

**Includes warrants to purchase 328,418
shares of Common Stock.

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