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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) | $ 8.58 | (3) | 10/21/2021 | Common Stock | 5,700 | 5,700 | D | ||||||||
Stock Option (right to buy) | $ 10 | (4) | 08/21/2022 | Common Stock | 2,750 | 2,750 | D | ||||||||
Stock Option (right to buy) | $ 14.19 | (5) | 07/14/2022 | Common Stock | 1,613 | 1,613 | D | ||||||||
Stock Option (right to buy) | $ 8.5 | (6) | 11/02/2027 | Common Stock | 26,900 | 26,900 | D | ||||||||
Stock Option (right to buy) | $ 5.55 | (7) | 02/22/2028 | Common Stock | 56,000 | 56,000 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Lolmaugh Cabell C/O TILE SHOP HOLDINGS, INC. 14000 CARLSON PARKWAY PLYMOUTH, MN 55441 |
Chief Operating Officer |
/s/ Amanda Lorentz as Attorney-in-Fact for Cabell Lolmaugh pursuant to Power of Attorney previously filed. | 10/19/2018 | |
**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 reporting person has elected to satisfy his tax withholding obligation in connection with the vesting of a prior restricted stock grant by directing the Company to withhold shares otherwise issuable pursuant to the previously reported grant. |
(2) | Includes (i) 9,036 shares of restricted stock for which the risks of forfeiture will lapse in installments of 3,012 shares on each of 10/17/19 , 10/17/20 and 10/17/21 and (ii) 22,500 shares of restricted stock for which the risks of forfeiture will lapse in installments of 5,625 shares on each of 2/22/19, 2/22/20, 2/22/21 and 2/22/22. |
(3) | Options to purchase 2,700 shares are vested and options to purchase 1,500 shares vest on each of 10/21/18 and 10/21/19. |
(4) | Fully vested. |
(5) | Options to purchase 969 shares are vested and options to purchase 322 shares vest on each of 7/14/19 and 7/14/20. |
(6) | Options to purchase 6,725 shares vest on each of 11/6/18, 11/6/19, 11/6/20 and 11/6/21. |
(7) | Options to purchase 14,000 shares vest on each of 2/22/19, 2/22/20, 2/22/21 and 2/22/22. |