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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) | $ 0.38 | 12/10/2019(2) | 12/10/2028 | Common Stock | 100,000 | 100,000 | D | ||||||||
Employee Stock Option (Right to Buy) | $ 0.36 | 03/14/2019 | A | 90,000 | 03/14/2020(3) | 03/14/2028 | Common Stock | 90,000 | $ 0 | 90,000 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Wamre Carmen 2400 XENIUM LANE NORTH PLYMOUTH, MN 55441 |
SVP, Chief Stores Officer |
/s/ Luke R. Komarek, Attorney-in-Fact | 03/18/2019 | |
**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) | This number includes restricted stock rewards. |
(2) | On December 10, 2018 the reporting person was granted an option to purchase 100,000 shares of the Company's Common Stock. The option vests in three annual installments of 33,334, 33,333 and 33,333 shares on December 10, 2019, December 10, 2020 and December 10, 2021 respectively. |
(3) | On March 14, 2019 the reporting person was granted an option to purchase 90,000 shares of the Company's Common Stock. The option vests in three annual installments of 30,000 shares on each of March 14, 2020, 2021 and 2022. |