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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 | ||||||||
Stock Option (Right to Buy) | $ 15 | 01/03/2019 | A | 43,750 | (3) | 01/03/2029 | Common Stock | 43,750 | $ 0 | 43,750 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Anderson Keith A C/O SKYLINE CHAMPION CORPORATION 2520 BY-PASS ROAD ELKHART, IN 46515 |
X | Chief Executive Officer |
/s/ Roger K. Scholten, Attorney-in-Fact | 01/07/2019 | |
**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) | Represents restricted stock units ("RSUs") granted to the Reporting Person under the Issuer's 2018 Equity Incentive Plan . Each RSU represents the contingent right to receive one share of Common Stock. Subject to the terms of the award agreement evidencing the grant of the RSUs, one-third of the RSUs vests on each of the first three anniversaries of July 1, 2018, provided that the Reporting Person remains in continuous service with the Issuer through each vesting date. |
(2) | Represents performance-based restricted stock units ("PRSUs") granted to the Reporting Person under the Issuer's 2018 Equity Incentive Plan. Each PRSU represents the contingent right to receive one share of Common Stock. Subject to the terms of the award agreement evidencing the grant of the PRSUs, vesting of a percentage of the PRSUs (including up to 150%) is dependent on the Issuer's total shareholder return from July 1, 2018 through July 1, 2021 relative to the total shareholder return of certain other companies over that same time period, provided that the Reporting Person remains in continuous service with the Issuer through each vesting date. |
(3) | The stock option will vest as to one-third of the shares subject to the stock option on each of July 1, 2019, July 1, 2020 and July 1, 2021, provided that the Reporting Person remains in continuous service with the Issuer through each vesting date. |