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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN 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. | |||
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. | SEC 1474 (9-02) |
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 Underlying Securities (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 of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Smith Brian K 5540 PIONEER CREEK DRIVE MAPLE PLAIN, MN 55359 |
X |
/s/ Julie M. Regnier, Attorney-in-Fact on behalf for Brian K. Smith | 08/23/2012 | |
**Signature of Reporting Person | Date |
* | 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). |
(1) | The transaction reported on this Form 4 represents a pro rata distribution, and not a purchase or sale of securities, by Protomold Investment Company, LLC ("PIC") to its members without consideration. On February 23, 2012, PIC and Brian K. Smith, due to his position as President of PIC and a director of Proto Labs, Inc. (the "Issuer"), filed a joint Form 3 with the Securities and Exchange Commission where PIC reported that it beneficially held 3,189,648 shares of the Issuer's common stock and Mr. Smith disclaimed any beneficial ownership of these shares except to the extent of his pecuniary interest. On July 12, 2012, Mr. Smith ceased to be the President, Chief Manager and Governor of PIC and Mr. Smith is now filing reports in his capacity as a director of the Issuer. |
(2) | Reflects the weighted average price of 20,000 shares of common stock of the Issuer sold by the reporting person in multiple transactions on August 23, 2012 with sale prices ranging from $32.25 to $32.27 per share. The reporting person undertakes to provide upon request by the U.S. Securities and Exchange Commission staff, the Issuer, or a security holder of the Issuer, full information regarding the number of shares sold at each separate price. |