SEC Form 5 · accession 0001601045-15-000001
Quotient Technology Inc. · QUOT
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Steven R. Boal
Officer — President & CEO · Director
Period of report
Dec 31, 2014
Accepted (ET)
Jan 22, 2015 · 6:47 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001115128
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | Nov 4, 2014 | J | 3,861,560 | $0.00 | A | 3,861,560 | I | By Family Trust |
| Common StockF1,F2 | Jan 15, 2015 | J | 45,267 | $0.00 | A | 3,906,827 | I | By Family Trust |
| Common StockF1,F3 | Jan 15, 2015 | J | 45,267 | $0.00 | A | 3,952,094 | I | By Family Trust |
| Common StockF2 | Jan 15, 2015 | J | 45,267 | $0.00 | D | 454,733 | I | By Trust |
| Common StockF3 | Jan 15, 2015 | J | 45,267 | $0.00 | D | 454,733 | I | By Wife Trust |
| Common Stock | holding | — | — | — | 1,367,569 | D | ||
| Common StockF4 | holding | — | — | — | 3,237 | I | By child Trust | |
| Common StockF5 | holding | — | — | — | 3,237 | I | By Child Trust | |
| Common StockF6 | holding | — | — | — | 3,237 | I | By Child Trust |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1These shares were previously reported as directly beneficially owned but were contributed on November 4, 2014 to the SMSEJ Family Trust U/A Dated July 18, 2005 of which Mr. Boal is a co-trustee.
- F2Represents shares transferred by the Annuity Trust of Mr. Boal. Mr. Boal simultaneously contributed these shares to the SMSEJ Family Trust Trust U/A Dated July 18, 2015 of which Mr. Boal is a co-trustee.
- F3Represents shares transferred by the Annuity Trust of Mrs. Boal. Mrs. Boal simultaneously contributed these shares to the SMSEJ Family Trust U/A Dated July 18, 2015 of which Mrs. Boal is a co-trustee.
- F4The shares are held directly by Stuart Shiff TTEE of the EBB 2011 Trust dated September 23, 2011
- F5The shares are held directly by Stuart Shiff TTEE of the JMB 2011 Trust dated September 23, 2011.
- F6The shares are held directly by Stuart Shiff TTEE of the SEB 2011 Trust dated September 23, 2011.