<SEC-DOCUMENT>0001437749-23-034766.txt : 20231218
<SEC-HEADER>0001437749-23-034766.hdr.sgml : 20231218
<ACCEPTANCE-DATETIME>20231218164444
ACCESSION NUMBER:		0001437749-23-034766
CONFORMED SUBMISSION TYPE:	SC 13D/A
PUBLIC DOCUMENT COUNT:		1
FILED AS OF DATE:		20231218
DATE AS OF CHANGE:		20231218

SUBJECT COMPANY:	

	COMPANY DATA:	
		COMPANY CONFORMED NAME:			AMERICAN SHARED HOSPITAL SERVICES
		CENTRAL INDEX KEY:			0000744825
		STANDARD INDUSTRIAL CLASSIFICATION:	SERVICES-MEDICAL LABORATORIES [8071]
		ORGANIZATION NAME:           	08 Industrial Applications and Services
		IRS NUMBER:				942918118
		STATE OF INCORPORATION:			CA
		FISCAL YEAR END:			1231

	FILING VALUES:
		FORM TYPE:		SC 13D/A
		SEC ACT:		1934 Act
		SEC FILE NUMBER:	005-36214
		FILM NUMBER:		231494388

	BUSINESS ADDRESS:	
		STREET 1:		601 MONTGOMERY STREET
		STREET 2:		SUITE 1112
		CITY:			SAN FRANCISCO
		STATE:			CA
		ZIP:			94111
		BUSINESS PHONE:		415-788-5300

	MAIL ADDRESS:	
		STREET 1:		601 MONTGOMERY STREET
		STREET 2:		SUITE 1112
		CITY:			SAN FRANCISCO
		STATE:			CA
		ZIP:			94111

FILED BY:		

	COMPANY DATA:	
		COMPANY CONFORMED NAME:			RUFFLE JOHN F
		CENTRAL INDEX KEY:			0001032011
		ORGANIZATION NAME:           	

	FILING VALUES:
		FORM TYPE:		SC 13D/A

	MAIL ADDRESS:	
		STREET 1:		77 PLEASANTVILLE ROAD
		CITY:			NEW VERNON
		STATE:			NJ
		ZIP:			07976
</SEC-HEADER>
<DOCUMENT>
<TYPE>SC 13D/A
<SEQUENCE>1
<FILENAME>ruffl20231218_sc13da.htm
<DESCRIPTION>SCHEDULE 13D/A
<TEXT>
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	<title>ruffl20231218_sc13da.htm</title>

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<p style="font-family:Times New Roman;font-size:12pt;font-variant:normal;text-align:center;margin:0pt;"><b>UNITED STATES</b></p>

<p style="font-family:Times New Roman;font-size:12pt;font-variant:normal;text-align:center;margin:0pt;"><b>SECURITIES AND EXCHANGE COMMISSION</b></p>

<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:center;margin:0pt;"><b>Washington, D.C. 20549</b></p>

<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:center;margin:0pt;">&nbsp;</p>

<hr style="text-align: center; height: 1px; color: #000000; background-color: #000000; width: 25%; border: none; margin: 3pt auto">
<p style="font-family:'Times New Roman';font-size:10pt;font-variant:normal;margin:0pt;">&nbsp;</p>

<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:center;margin:0pt;"><b>SCHEDULE 13D/A</b></p>

<p style="font-family:'Times New Roman';font-size:10pt;font-variant:normal;margin:0pt;">&nbsp;</p>

<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:center;margin:0pt;"><b>Under The Securities Exchange Act Of 1934</b></p>

<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:center;margin:0pt;"><b>(Amendment No. 4)*</b></p>

<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:center;margin:0pt;">&nbsp;</p>

<hr style="text-align: center; height: 1px; color: #000000; background-color: #000000; width: 25%; border: none; margin: 3pt auto">
<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:center;margin:0pt;">&nbsp;</p>

<p style="font-family:Times New Roman;font-size:12pt;font-variant:normal;text-align:center;margin:0pt;"><b>American Shared Hospital Services</b></p>

<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:center;margin:0pt;">(Name of Issuer)</p>

<p style="font-family:'Times New Roman';font-size:10pt;font-variant:normal;margin:0pt;">&nbsp;</p>

<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:center;margin:0pt;"><b>Common Stock, no par value</b></p>

<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:center;margin:0pt;">(Title of Class of Securities)</p>

<p style="font-family:'Times New Roman';font-size:10pt;font-variant:normal;margin:0pt;">&nbsp;</p>

<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:center;margin:0pt;"><b>029595-10-5</b></p>

<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:center;margin:0pt;">(CUSIP Number)</p>

<p style="font-family:'Times New Roman';font-size:10pt;font-variant:normal;margin:0pt;">&nbsp;</p>

<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:center;margin:0pt;"><b>John F. Ruffle</b></p>

<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:center;margin:0pt;"><b>603 Mountain Avenue</b></p>

<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:center;margin:0pt;"><b>Apartment 231 </b></p>

<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:center;margin:0pt;"><b>New Providence, New Jersey 07974 </b></p>

<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:center;margin:0pt;"><b>(973) 769-1232</b></p>

<p style="font-family:'Times New Roman';font-size:10pt;font-variant:normal;margin:0pt;">&nbsp;</p>

<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:center;margin:0pt;"><b>with a copy to:</b></p>

<p style="font-family:'Times New Roman';font-size:10pt;font-variant:normal;margin:0pt;">&nbsp;</p>

<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:center;margin:0pt;"><b>Joseph R. DeHondt</b></p>

<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:center;margin:0pt;"><b>Dykema Gossett PLLC</b></p>

<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:center;margin:0pt;"><b>39577 Woodward Avenue</b></p>

<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:center;margin:0pt;"><b>Suite 300</b></p>

<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:center;margin:0pt;"><b>Bloomfield Hills, Michigan 48304</b></p>

<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:center;margin:0pt;"><b>(248) 203-0700</b></p>

<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:center;margin:0pt;">(Name, Address and Telephone Number of Person Authorized to Receive Notices and Communications)</p>

<p style="font-family:'Times New Roman';font-size:10pt;font-variant:normal;margin:0pt;">&nbsp;</p>

<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:center;margin:0pt;"><b>February 28, 2023</b></p>

<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:center;margin:0pt;">(Date of Event Which Requires Filing of This Statement)</p>

<p style="font-family:'Times New Roman';font-size:10pt;font-variant:normal;margin:0pt;">&nbsp;</p>

<hr style="text-align: center; height: 1px; color: #000000; background-color: #000000; width: 25%; border: none; margin: 3pt auto">
<p style="font-family:'Times New Roman';font-size:10pt;font-variant:normal;margin:0pt;">&nbsp;</p>

<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:justify;margin:0pt;">If the filing person has previously filed a statement on Schedule 13G to report the acquisition that is the subject of this Schedule&nbsp;13D, and is filing this schedule because of &#167;&#167; 240.13d-1(e), 240.13d-1(f) or 240.13d-1(g), check the following box. &#9744;</p>

<p style="font-family:'Times New Roman';font-size:10pt;font-variant:normal;margin:0pt;">&nbsp;</p>

<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:justify;margin:0pt;">* The remainder of this cover page shall be filled out for a reporting person&#8217;s initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter disclosures provided in a prior cover page.</p>

<p style="font-family:'Times New Roman';font-size:10pt;font-variant:normal;margin:0pt;">&nbsp;</p>

<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:justify;margin:0pt;">The information required in the remainder of this cover page shall not be deemed to be &#8220;filed&#8221; for the purpose of Section 18 of the Securities Exchange Act of 1934 (the &#8220;Act&#8221;) or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however, see the&nbsp;Notes).</p>

<p style="font-family:'Times New Roman';font-size:10pt;font-variant:normal;margin:0pt;text-indent:9pt;">&nbsp;</p>

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<p style="font-family: 'Times New Roman', Times, serif; font-size: 10pt; margin: 0pt; text-align: left">&nbsp;</p>

<table border="0" cellpadding="0" cellspacing="0" style="font-family: Times New Roman; font-size: 10pt; width: 100%;">

		<tr>
			<td colspan="3" style="border-width: 1px; border-style: solid; border-color: black black rgb(0, 0, 0); vertical-align: middle; width: 13%;">
			<p style="font-family: Times New Roman; font-size: 10pt; font-variant: normal; margin: 0pt 0pt 0pt 9pt;">CUSIP NO. 029595-10-5</p>
			</td>
		</tr>
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			<td style="border-bottom: 1px solid rgb(0, 0, 0); vertical-align: middle; width: 8%; border-right: 1px solid black; border-left: 1px solid black;">
			<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:center;margin:0pt;">1</p>
			</td>
			<td colspan="2" style="border-bottom: 1px solid rgb(0, 0, 0); vertical-align: middle; width: 5%; border-right: 1px solid black;">
			<p style="font-family: Times New Roman; font-size: 10pt; font-variant: normal; margin: 0pt 0pt 0pt 9pt;">Name of Reporting Person</p>

			<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;margin:0pt;">&nbsp;</p>

			<p style="font-family: Times New Roman; font-size: 10pt; font-variant: normal; margin: 0pt 0pt 0pt 9pt;"><b>John F. Ruffle</b></p>
			</td>
		</tr>
		<tr>
			<td style="border-bottom: 1px solid rgb(0, 0, 0); vertical-align: middle; width: 8%; border-right: 1px solid black; border-left: 1px solid black;">
			<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:center;margin:0pt;">2</p>
			</td>
			<td colspan="2" style="border-bottom: 1px solid rgb(0, 0, 0); vertical-align: middle; width: 5%; border-right: 1px solid black;">
			<p style="font-family: Times New Roman; font-size: 10pt; font-variant: normal; margin: 0pt 0pt 0pt 9pt;">Check the Appropriate Box if a Member of a Group (See Instructions):</p>

			<p style="font-family: Times New Roman; font-size: 10pt; font-variant: normal; margin: 0pt 0pt 0pt 9pt;">(a) &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&#9744;</p>

			<p style="font-family: Times New Roman; font-size: 10pt; font-variant: normal; margin: 0pt 0pt 0pt 9pt;">(b) &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&#9744;</p>
			</td>
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			<td style="border-bottom: 1px solid rgb(0, 0, 0); vertical-align: middle; width: 8%; border-right: 1px solid black; border-left: 1px solid black;">
			<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:center;margin:0pt;">3</p>
			</td>
			<td colspan="2" style="border-bottom: 1px solid rgb(0, 0, 0); vertical-align: middle; width: 5%; border-right: 1px solid black;">
			<p style="font-family: Times New Roman; font-size: 10pt; font-variant: normal; margin: 0pt 0pt 0pt 9pt;">SEC Use Only</p>

			<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;margin:0pt;">&nbsp;</p>

			<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;margin:0pt;">&nbsp;</p>
			</td>
		</tr>
		<tr>
			<td style="border-bottom: 1px solid rgb(0, 0, 0); vertical-align: middle; width: 8%; border-right: 1px solid black; border-left: 1px solid black;">
			<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:center;margin:0pt;">4</p>
			</td>
			<td colspan="2" style="border-bottom: 1px solid rgb(0, 0, 0); vertical-align: middle; width: 5%; border-right: 1px solid black;">
			<p style="font-family: Times New Roman; font-size: 10pt; font-variant: normal; margin: 0pt 0pt 0pt 9pt;">Source of Funds (See Instructions):</p>

			<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;margin:0pt;">&nbsp;</p>

			<p style="font-family: Times New Roman; font-size: 10pt; font-variant: normal; margin: 0pt 0pt 0pt 9pt;"><b>PF</b></p>
			</td>
		</tr>
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			<td style="border-bottom: 1px solid rgb(0, 0, 0); vertical-align: middle; width: 8%; border-right: 1px solid black; border-left: 1px solid black;">
			<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:center;margin:0pt;">5</p>
			</td>
			<td colspan="2" style="border-bottom: 1px solid rgb(0, 0, 0); vertical-align: middle; width: 5%; border-right: 1px solid black;">
			<p style="font-family: Times New Roman; font-size: 10pt; font-variant: normal; margin: 0pt 0pt 0pt 9pt;">Check if Disclosure of Legal Proceedings is Required Pursuant to Items 2(d) or 2(e):</p>

			<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;margin:0pt;">&nbsp;</p>

			<p style="font-family: Times New Roman; font-size: 10pt; font-variant: normal; margin: 0pt 0pt 0pt 9pt;"><b>Not Applicable.</b></p>
			</td>
		</tr>
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			<td style="border-bottom: 1px solid rgb(0, 0, 0); vertical-align: middle; width: 8%; border-right: 1px solid black; border-left: 1px solid black;">
			<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:center;margin:0pt;">6</p>
			</td>
			<td colspan="2" style="border-bottom: 1px solid rgb(0, 0, 0); vertical-align: middle; width: 5%; border-right: 1px solid black;">
			<p style="font-family: Times New Roman; font-size: 10pt; font-variant: normal; margin: 0pt 0pt 0pt 9pt;">Citizenship or Place of Organization</p>

			<p style="font-family: Times New Roman; font-size: 10pt; font-variant: normal; margin: 0pt 0pt 0pt 9pt;">&nbsp;</p>

			<p style="font-family: Times New Roman; font-size: 10pt; font-variant: normal; margin: 0pt 0pt 0pt 9pt;"><b>United States</b></p>
			</td>
		</tr>
		<tr>
			<td style="vertical-align: bottom; width: 8%; border-right: 1px solid black; border-left: 1px solid black;">
			<p style="font-family: Times New Roman; font-size: 10pt; font-variant: normal; margin: 0pt 0pt 0pt 9pt;">Number of</p>
			</td>
			<td style="border-bottom: 1px solid rgb(0, 0, 0); vertical-align: middle; width: 5%;">
			<p style="font-family: Times New Roman; font-size: 10pt; font-variant: normal; margin: 0pt; text-align: center;">7</p>
			</td>
			<td style="border-bottom: 1px solid rgb(0, 0, 0); vertical-align: middle; width: 87%; border-right: 1px solid black; border-left: 1px solid black;">
			<p style="font-family: Times New Roman; font-size: 10pt; font-variant: normal; text-align: justify; margin: 0pt 0pt 0pt 9pt;">Sole Voting Power</p>

			<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:justify;margin:0pt;">&nbsp;</p>

			<p style="font-family: Times New Roman; font-size: 10pt; font-variant: normal; text-align: justify; margin: 0pt 0pt 0pt 9pt;"><b>410,746</b></p>
			</td>
		</tr>
		<tr>
			<td style="vertical-align: middle; width: 8%; border-right: 1px solid black; border-left: 1px solid black; text-align: center;">
			<p style="margin: 0pt 0pt 0pt 9pt; font-size: 10pt; font-family: Times New Roman; text-align: left;">shares</p>

			<p style="margin: 0pt 0pt 0pt 9pt; font-size: 10pt; font-family: Times New Roman; text-align: left;">beneficially</p>

			<p style="margin: 0pt 0pt 0pt 9pt; font-size: 10pt; font-family: Times New Roman; text-align: left;">owned by</p>
			</td>
			<td style="border-bottom: 1px solid rgb(0, 0, 0); vertical-align: middle; width: 5%;">
			<p style="font-family: Times New Roman; font-size: 10pt; font-variant: normal; margin: 0pt; text-align: center;">8</p>
			</td>
			<td style="border-bottom: 1px solid rgb(0, 0, 0); vertical-align: middle; width: 87%; border-right: 1px solid black; border-left: 1px solid black;">
			<p style="font-family: Times New Roman; font-size: 10pt; font-variant: normal; text-align: justify; margin: 0pt 0pt 0pt 9pt;">Shared Voting Power</p>

			<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:justify;margin:0pt;">&nbsp;</p>

			<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:justify;margin:0pt;">&nbsp;</p>
			</td>
		</tr>
		<tr>
			<td style="vertical-align: top; width: 8%; border-right: 1px solid black; border-left: 1px solid black; text-align: center;">
			<p style="margin: 0pt 0pt 0pt 9pt; font-size: 10pt; font-family: Times New Roman; text-align: left;">each</p>

			<p style="margin: 0pt 0pt 0pt 9pt; font-size: 10pt; font-family: Times New Roman; text-align: left;">reporting</p>

			<p style="margin: 0pt 0pt 0pt 9pt; font-size: 10pt; font-family: Times New Roman; text-align: left;">person with:</p>
			</td>
			<td style="border-bottom: 1px solid rgb(0, 0, 0); vertical-align: middle; width: 5%;">
			<p style="font-family: Times New Roman; font-size: 10pt; font-variant: normal; margin: 0pt; text-align: center;">9</p>
			</td>
			<td style="border-bottom: 1px solid rgb(0, 0, 0); vertical-align: middle; width: 87%; border-right: 1px solid black; border-left: 1px solid black;">
			<p style="font-family: Times New Roman; font-size: 10pt; font-variant: normal; text-align: justify; margin: 0pt 0pt 0pt 9pt;">Sole Dispositive Power</p>

			<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:justify;margin:0pt;">&nbsp;</p>

			<p style="font-family: Times New Roman; font-size: 10pt; font-variant: normal; text-align: justify; margin: 0pt 0pt 0pt 9pt;"><b>410,746</b></p>
			</td>
		</tr>
		<tr>
			<td style="border-bottom: 1px solid rgb(0, 0, 0); vertical-align: middle; width: 8%; border-right: 1px solid black; border-left: 1px solid black;">&nbsp;</td>
			<td style="border-bottom: 1px solid rgb(0, 0, 0); vertical-align: middle; width: 5%;">
			<p style="font-family: Times New Roman; font-size: 10pt; font-variant: normal; margin: 0pt; text-align: center;">10</p>
			</td>
			<td style="border-bottom: 1px solid rgb(0, 0, 0); vertical-align: middle; width: 87%; border-right: 1px solid black; border-left: 1px solid black;">
			<p style="font-family: Times New Roman; font-size: 10pt; font-variant: normal; text-align: justify; margin: 0pt 0pt 0pt 9pt;">Shared Dispositive Power</p>

			<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:justify;margin:0pt;">&nbsp;</p>

			<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:justify;margin:0pt;">&nbsp;</p>
			</td>
		</tr>
		<tr>
			<td style="border-bottom: 1px solid rgb(0, 0, 0); vertical-align: middle; width: 8%; border-right: 1px solid black; border-left: 1px solid black;">
			<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:center;margin:0pt;">11</p>
			</td>
			<td colspan="2" style="border-bottom: 1px solid rgb(0, 0, 0); vertical-align: middle; width: 5%; border-right: 1px solid black;">
			<p style="font-family: Times New Roman; font-size: 10pt; font-variant: normal; text-align: justify; margin: 0pt 0pt 0pt 9pt;">Aggregate Amount Beneficially Owned By Each Reporting Person</p>

			<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:justify;margin:0pt;">&nbsp;</p>

			<p style="font-family: Times New Roman; font-size: 10pt; font-variant: normal; text-align: justify; margin: 0pt 0pt 0pt 9pt;"><b>410,746</b></p>
			</td>
		</tr>
		<tr>
			<td style="border-bottom: 1px solid rgb(0, 0, 0); vertical-align: middle; width: 8%; border-right: 1px solid black; border-left: 1px solid black;">
			<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:center;margin:0pt;">12</p>
			</td>
			<td colspan="2" style="border-bottom: 1px solid rgb(0, 0, 0); vertical-align: middle; width: 5%; border-right: 1px solid black;">
			<p style="font-family: Times New Roman; font-size: 10pt; font-variant: normal; text-align: justify; margin: 0pt 0pt 0pt 9pt;">Check Box If The Aggregate Amount In Row (11) Excludes Certain Shares (See Instructions): &#9744;</p>

			<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:justify;margin:0pt;">&nbsp;</p>

			<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:justify;margin:0pt;">&nbsp;</p>
			</td>
		</tr>
		<tr>
			<td style="border-bottom: 1px solid rgb(0, 0, 0); vertical-align: middle; width: 8%; border-right: 1px solid black; border-left: 1px solid black;">
			<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:center;margin:0pt;">13</p>
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			<p style="font-family: Times New Roman; font-size: 10pt; font-variant: normal; text-align: justify; margin: 0pt 0pt 0pt 9pt;">Percent Of Class Represented By Amount In Row 11</p>

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			<p style="font-family: Times New Roman; font-size: 10pt; font-variant: normal; text-align: justify; margin: 0pt 0pt 0pt 9pt;"><b>6.5% (1)</b></p>
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			<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:center;margin:0pt;">14</p>
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			<p style="font-family: Times New Roman; font-size: 10pt; font-variant: normal; text-align: justify; margin: 0pt 0pt 0pt 9pt;">Type Of Reporting Person</p>

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			<p style="font-family: Times New Roman; font-size: 10pt; font-variant: normal; text-align: justify; margin: 0pt 0pt 0pt 9pt;"><b>IN</b></p>
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			<p style="margin: 0pt; text-align: justify; font-family: &quot;Times New Roman&quot;, Times, serif; font-size: 10pt;">Based on American Shared Hospital Services (the &#8220;Issuer&#8221;) having an aggregate of 6,300,000 shares of common stock issued and outstanding as of November 9, 2023, as reported in the Issuer&#8217;s quarterly report on Form 10-Q for the quarterly period ended September 30, 2023.</p>
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<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:center;margin:0pt;"><b>EXPLANATORY NOTE</b></p>

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<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:justify;margin:0pt;text-indent:36pt;">This Schedule 13D/A constitutes Amendment No. 4 (this &#8220;<b><i>Schedule 13D/A No. 4</i></b>&#8221;) to the Schedule&nbsp;13D originally filed by John F. Ruffle (&#8220;<b><i>Mr. Ruffle</i></b>&#8221;) with the Securities and Exchange Commission (the &#8220;<b><i>SEC</i></b>&#8221;) on June&nbsp;27, 2011 and amended by Schedules 13D/A filed on June&nbsp;18, 2014, October&nbsp;27, 2014, and January 20, 2016 (as amended, the &#8220;<b><i>Original Schedule</i></b>&nbsp;<b><i>13D</i></b>&#8221;) with respect to the common stock, no par value (the &#8220;<b><i>Common Stock</i></b>&#8221;), of American Shared Hospital Services, a California corporation (the &#8220;<b><i>Issuer</i></b>&#8221;). Only those items that are reported in this Schedule&nbsp;13D/A No. 4 are amended; all other items reported in the Original Schedule 13D remain unchanged. Information given in response to each item shall be deemed incorporated by reference in all other items, as applicable. Capitalized terms used but not defined in this Schedule 13D/A No. 4 have the meanings given to them in the Original Schedule&nbsp;13D.</p>

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<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:justify;margin:0pt;"><b>Item 1.</b>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<b><i>Security and Issuer.</i></b></p>

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<p style="font-family: Times New Roman; font-size: 10pt; font-variant: normal; text-align: justify; margin: 0pt; text-indent: 36pt;">The address of the Issuer&#8217;s principal executive office is 601 Montgomery Street, Suite 1112, San Francisco, California 94111-2619.</p>

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<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:justify;margin:0pt;"><b>Item 2.</b>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<b><i>Identity and Background.</i></b></p>

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<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:justify;margin:0pt;text-indent:36pt;"><b>(a)</b>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;The name of the person filing this Schedule&nbsp;13D/A No. 4 is John F. Ruffle.</p>

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<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:justify;margin:0pt;text-indent:36pt;"><b>(b)</b>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;The residence of Mr. Ruffle is 603 Mountain Ave., Apt. 231, New Providence, NJ 07974.</p>

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<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:justify;margin:0pt;text-indent:36pt;"><b>(c)</b>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Mr. Ruffle, a former director of the Issuer, is presently retired and an Emeritus Trustee of the Board of Trustees of Johns Hopkins University.</p>

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<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:justify;margin:0pt;text-indent:36pt;"><b>(d)</b>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;During the last five years, Mr. Ruffle has not been convicted in a criminal proceeding (excluding traffic violations or similar misdemeanors).</p>

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<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:justify;margin:0pt;text-indent:36pt;"><b>(e)</b> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;During the last five years, Mr. Ruffle has not been a party to a civil proceeding of a judicial or administrative body of competent jurisdiction that resulted in Mr. Ruffle being subject to a judgment, decree, or final order enjoining future violations of, or prohibiting or mandating activities subject to, federal or state securities laws or finding any violation with respect to such laws.</p>

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<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:justify;margin:0pt;text-indent:36pt;"><b>(f) </b>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Mr. Ruffle is a United States citizen.</p>

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<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:justify;margin:0pt;"><b>Item 3.</b>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<b><i>Source and Amount of Funds or Other Consideration.</i></b></p>

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<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:justify;margin:0pt;text-indent:36pt;">On February 28, 2023, Mr. Ruffle transferred 141,000 shares of Common Stock (the &#8220;<b><i>Transferred Shares</i></b>&#8221;) as a gift for no consideration to the Ruffle Family Foundation (the &#8220;<b><i>Foundation</i></b>&#8221;), a donor-advised fund established through the J.P. Morgan Charitable Giving Fund, which is administered by the National Philanthropic Trust. Upon Mr.&nbsp;Ruffle&#8217;s donation to the Foundation, he ceased having control over the Transferred Shares and was informed that the Transferred Shares were sold by the National Philanthropic Trust. After the transfer, Mr.&nbsp;Ruffle retained voting and dispositive power over a total of 410,746 shares of Common Stock.</p>

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<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:justify;margin:0pt;"><b>Item 4.</b>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<b><i>Purpose of Transaction.</i></b></p>

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<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:justify;margin:0pt;text-indent:36pt;">The information reported in Item 3 of this Schedule 13D is incorporated by reference into this Item 4 to the extent applicable. Mr. Ruffle donated the Transferred Shares to the Foundation for estate planning and charitable purposes.</p>

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<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:justify;margin:0pt;text-indent:36pt;">Mr. Ruffle does not have any current plans or proposals that relate to or would result in any of the matters specified in subparagraphs (a) through (j) of Item&nbsp;4 of Schedule 13D. Mr. Ruffle reserves the right to increase or decrease his position in the Issuer through, among other things, the purchase or sale of securities of the Issuer on the open market, in private transactions, or otherwise, on such terms and at such times as Mr. Ruffle may deem advisable.</p>

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<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:justify;margin:0pt;text-indent:36pt;"><b>(a)</b>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;The aggregate percentage of shares of Common Stock reported as beneficially owned by Mr.&nbsp;Ruffle is based on the Issuer having an aggregate of 6,300,000 shares of Common Stock issued and outstanding as of November&nbsp;9, 2023, as reported in the Issuer&#8217;s quarterly report on Form 10-Q for the quarterly period ended September&nbsp;30, 2023, which the Issuer filed with the SEC on November&nbsp;14, 2023. As of the filing date of this Schedule&nbsp;13D/A No. 4 (the &#8220;<b><i>Filing Date</i></b>&#8221;): Mr. Ruffle beneficially owns 410,746 shares of Common Stock, which represents approximately 6.5% of the issued and outstanding shares of the Issuer&#8217;s Common Stock.</p>

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<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:justify;margin:0pt;text-indent:36pt;"><b>(b)</b>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;As of the Filing Date, Mr. Ruffle has sole power to vote or to direct the voting of, and to dispose or to direct the disposition of, 410,746 shares of Common Stock, all of which are directly held by Mr. Ruffle.</p>

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<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:justify;margin:0pt;text-indent:36pt;"><b>(c)</b>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Mr. Ruffle has not effected any transactions in the Issuer&#8217;s Common Stock during the past 60 days.</p>

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<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:justify;margin:0pt;text-indent:36pt;"><b>(d)</b>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;No person except for Mr.&nbsp;Ruffle has the right to receive or the power to direct the receipt of dividends from, or the proceeds from the sale of, any shares of Common Stock beneficially owned by Mr. Ruffle.</p>

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<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:justify;margin:0pt;text-indent:36pt;"><b>(e)</b>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Not applicable.</p>

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<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:justify;margin:0pt;"><b>Item 6.</b>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<b><i>Contracts, Arrangements, Understandings or Relationships With Respect to Securities of the Issuer.</i></b></p>

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<p style="font-family: Times New Roman; font-size: 10pt; font-variant: normal; text-align: justify; margin: 0pt; text-indent: 36pt;">There are no contracts, arrangements, understandings, or similar relationships between Mr.&nbsp;Ruffle and any other person with respect to the securities of the Issuer.</p>

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<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:center;margin:0pt;"><b>SIGNATURES</b></p>

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<p style="font-family:Times New Roman;font-size:10pt;font-variant:normal;text-align:justify;margin:0pt;text-indent:36pt;">After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct.</p>

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			<p style="margin: 0px 0pt; font-size: 10pt; font-family: &quot;Times New Roman&quot;, Times, serif;"><i>/s/ John F. Ruffle</i></p>
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			<td valign="top" width="35%">John F. Ruffle</td>
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