UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | SEC 1473 (7-02) | ||
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 control number. |
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 of Derivative Security: Direct (D) or Indirect (I) (Instr. 5) |
6. Nature of Indirect Beneficial Ownership (Instr. 5) |
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Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
Options | Â (2) | 01/27/2022 | Common Stock | 39,250 | $ 4 | D | Â |
Options | Â (2) | 01/27/2022 | Common Stock | 39,250 | $ 8 | D | Â |
Options | Â (2) | 12/20/2022 | Common Stock | 14,945 | $ 7.47 | D | Â |
Options | Â (2) | 12/20/2022 | Common Stock | 14,945 | $ 11.21 | D | Â |
Options | Â (3) | 01/27/2022 | Common Stock | 58,875 | $ 2 | D | Â |
Options | Â (3) | 01/27/2022 | Common Stock | 58,875 | $ 6 | D | Â |
Options | Â (4) | 12/20/2022 | Common Stock | 59,780 | $ 5.47 | D | Â |
Options | Â (4) | 12/20/2022 | Common Stock | 59,780 | $ 9.21 | D | Â |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
STARRETT PETER C/O BOOT BARN HOLDINGS, INC. 15776 LAGUNA CANYON ROAD IRVINE, CA 92618 |
 X |  |  |  |
/s/ Peter Starrett | 10/29/2014 | |
**Signature of Reporting Person | Date |
* | 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). |
(1) | By Peter Starrett as trustee of The Starrett Family Trust, Dated April 11, 1999. |
(2) | The Options were granted under the Company's 2011 Equity Incentive Plan and are fully vested. |
(3) | The Options were granted under the Company's 2011 Equity Incentive Plan. 19,625 of these Options will become exercisable on each of January 27, 2015, Janurary 27, 2016 and January 27, 2017. |
(4) | The Options were granted under the Company's 2011 Equity Incentive Plan. 14,945 of these Options will become exercisable on each of December 20, 2014, December 20, 2015, December 20, 2016 and December 20, 2017. |