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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 | ||||||||
Employee Stock Option (Right to Buy) | $ 74.57 | 10/26/2018 | A | 1,132 (3) | 10/26/2018 | 02/15/2028 | Common Stock | 1,132 | $ 0 | 3,337 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Coelho Mary Theresa C/O BALCHEM CORPORATION 52 SUNRISE PARK ROAD NEW HAMPTON, NY 10958 |
Chief Financial Officer |
/s/ Mary Theresa Coelho, by Attorney in Fact, Mark Stach | 10/29/2018 | |
**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 Company granted 5,605 restricted shares under the Company's Long-Term Incentive Program. The shares were subject to certain restrictions under the applicable Restricted Stock Grant Agreements. 1,187 of the 3,210 shares that vested October 26, 2018 were withheld to cover withholding taxes due upon vesting. |
(2) | In connection with a Separation Agreement and General Release (SA&GR) between the Company and the reporting person, 1,050 shares previously reported as beneficially owned in connection with Restricted Stock Grant Agreements were forfeited. |
(3) | On February 15, 2018, the reporting person was granted an option to purchase 5,030 shares of common stock scheduled to vest in installments of 20%, 40%, and 40% per year over the three-year period. The option reported herein as acquired resulted from the acceleration of vesting of 22.5% of such option in connection with a SA&GR. |