SEC Form 5 · accession 0001209191-17-009544
FAIRMOUNT SANTROL HOLDINGS INC. · FMSA
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Jenniffer D. Deckard
Officer — President and CEO · Director
Period of report
Dec 31, 2016
Accepted (ET)
Feb 10, 2017 · 4:25 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001010858
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | Nov 7, 2016 | G | 125,000 | $0.00 | D | 2,098,268 | I | As trustee of Jenniffer D. Deckard Family Trust U/A/D dated February 28, 2010 |
| Common StockF2 | holding | — | — | — | 62,586 | D | ||
| Common StockF2 | holding | — | — | — | 6,240 | I | By Spouse | |
| Common Stock | holding | — | — | — | 857,888 | I | As trustee of the Abbey Jo Deckard Trust | |
| Common Stock | holding | — | — | — | 857,888 | I | As trustee of the Connor John Deckard Trust | |
| Common Stock | holding | — | — | — | 102,000 | I | As trustee of Daryl K. Deckard Irrrevocable Trust dated August 29, 2014 | |
| Common Stock | holding | — | — | — | 353,600 | I | As spouse to the trustee of Jenniffer D. Deckard Irrevocable Trust dated December 27, 2012 | |
| Common Stock | holding | — | — | — | 386,563 | I | By 401(k) Plan |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1Shares previously reported as being held by the Jenniffer Deckard Grantor Retained Annuity Trust #3 dated August 7, 2014 are now reported as held in the Jenniffer D. Deckard Family Trust U/A/D dated February 28, 2010.
- F2The total number of shares of Common Stock represent grants of restricted stock units.