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 | ||||
Non-Qualified Stock Options | 12/06/2018 | 12/06/2027 | Non-Qualified Stock Options (2) | 7,711 | $ 19 | D | Â |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
MARTIN GINA L. 313 CONGRESS STREET BOSTON, MA 02210 |
 |  |  *See Remarks |  |
/s/ Gina L. Martin | 01/10/2018 | |
**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) | Includes 3,680 shares of Common Stock and 193 restricted stock units that vest on March 5, 2018, 577 restricted stock units that vest on December 3, 2018, 1,792 restricted stock units that vest in two equal annual increments on December 6, 2018 and December 6, 2019, 5,000 restricted stock units that vest in two equal increments over a three-year period, with the first vesting date on July 3, 2019, and 5,625 restricted stock units that vest in three equal annual increments over a three-year period, with the first vesting date on December 8, 2018. The restricted stock units are subject to the terms and conditions of the Civitas Solutions, Inc. 2014 Omnibus Incentive Plan. |
(2) | The stock options are subject to the terms and conditions of Civitas Solutions, Inc. 2014 Omnibus Plan, and vest in three equal annual increments over a three-year period, with the first vesting date on December 6, 2018. |
 Remarks: Chief Legal Officer, General Counsel & Secretary |