|
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 |
|
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
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) |
||||
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
CROWLEY WILLIAM C C/O ORCHARD SUPPLY HARDWARE STORES CORP. 6450 VIA DEL ORO SAN JOSE, CA 95119 |
X | X |
/s/ Michael W. Fox, by Power of Attorney | 06/25/2012 | |
**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 individual received a restricted stock award of 3,009 shares under the Orchard Supply Hardware Stores Corporation Director Compensation Policy, of which 753 shares shall vest on September 21, 2012, 752 shares shall vest on December 21, 2012, 752 shares shall vest on March 21, 2013 and 752 shares shall vest on June 21, 2013 or the date of the Company's 2013 annual meeting of stockholders. |
(2) | This grant was issued pursuant to an election to receive shares of Orchard Supply Hardware Stores Corporation Class A Common Stock in lieu of the cash portion of director compensation under the Orchard Supply Hardware Stores Corporation Director Compensation Policy. Of such grant, 753 shares shall vest on September 21, 2012, 752 shares shall vest on December 21, 2012, 752 shares shall vest on March 21, 2013 and 752 shares shall vest on June 21, 2013 or the date of the Company's 2013 annual meeting of stockholders. |
(3) | Represents securities directly held by Tynan, LLC ("Tynan"). The reporting individual is the manager and a member of, and may be deemed to beneficially own securities owned by, Tynan. |
(4) | These shares are held in a grantor retained annuity trust, of which the reporting individual is the trustee. |