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

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

Page 6 of 8 – SEC Filing

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