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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 | |
STADIUM CAPITAL MANAGEMENT LLC 199 ELM STREET NEW CANAAN, CT 06840-5321 |
X | X | ||
STADIUM CAPITAL PARTNERS L P 199 ELM STREET NEW CANAAN, CT 06840-5321 |
X | X | ||
STADIUM CAPITAL QUALIFIED PARTNERS LP 199 ELM STREET NEW CANAAN, CT 06840-5321 |
X | X | ||
SEAVER ALEXANDER M 199 ELM STREET NEW CANAAN, CT 06840-5321 |
X | X | ||
KENT BRADLEY R 1000 NW WALL STREET, SUITE 210 BEND, OR 97701 |
X | X | ||
Stadium Capital Management GP, L.P. 199 ELM STREET NEW CANAAN, CT 06840-5321 |
X | X |
Stadium Capital Partners, L.P., by Stadium Capital Management GP, L.P., its general partner, by Stadium Capital Management, LLC, its general partner, by Bradley R. Kent, Manager | 11/05/2014 | |
**Signature of Reporting Person | Date | |
Stadium Capital Qualified Partners, L.P., by Stadium Capital Management GP, L.P., its general partner, by Stadium Capital Management, LLC, its general partner, by Bradley R. Kent, Manager | 11/05/2014 | |
**Signature of Reporting Person | Date | |
Bradley R. Kent | 11/05/2014 | |
**Signature of Reporting Person | Date | |
Alexander M. Seaver | 11/05/2014 | |
**Signature of Reporting Person | Date | |
Stadium Capital Management GP, L.P., by Stadium Capital Management, LLC, its general partner by Bradley R.Kent, Manager | 11/05/2014 | |
**Signature of Reporting Person | Date | |
Stadium Capital Management, LLC, by Bradley R. Kent, Manager | 11/05/2014 | |
**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) | Disposed of pursuant to a Plan of Merger between Intermountain Community Bancorp and Columbia Banking Systems, Inc., dated July 23, 2014. |
(2) | The reported securities are owned directly by Stadium Capital Partners, L.P., and indirectly by Stadium Capital Management, LLC as general partner of Stadium Capital Management GP, L.P., which is general partner of Stadium Capital Partners, L.P., Alexander M. Seaver as a manager of Stadium Capital Management, LLC, and Bradley R. Kent as a manager of Stadium Capital Management, LLC. Stadium Capital Management, LLC, Stadium Capital Management GP, L.P., Alexander M. Seaver and Bradley R. Kent disclaim beneficial ownership of the reported securities except to the extent of their respective pecuniary interests therein. |
(3) | The reported securities are owned directly by Stadium Capital Qualified Partners, L.P., and indirectly by Stadium Capital Management, LLC as general partner of Stadium Capital Management GP, L.P., which is general partner of Stadium Capital Qualified Partners, L.P., Alexander M. Seaver as a manager of Stadium Capital Management, LLC, and Bradley R. Kent as a manager of Stadium Capital Management, LLC. Stadium Capital Management, LLC, Stadium Capital Management GP, L.P.,Alexander M. Seaver and Bradley R. Kent disclaim beneficial ownership of the reported securities except to the extent of their respective pecuniary interests therein |
Remarks: Stadium Capital Partners, L.P. and Stadium Capital Qualified Partners, L.P. are jointly entitled to appoint a representative to Intermountain's board of directors pursuant to their respective securities purchase agreements as reported by Intermountain in a Form 8-K filed with the SEC on 1/23/12. John L. Welborn Jr. was appointed to the board of Intermountain pursuant to these contractual rights. |