SEC Form 5/A · accession 0001601045-18-000007
Quotient Technology Inc. · QUOT
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
This is an amendment (Form 5/A). It replaces an earlier filing for the same period.
Reporting owner
Steven R. Boal
Officer — Executive Chairman · Director
Period of report
Dec 31, 2017
Accepted (ET)
May 18, 2018 · 8:08 pm EDT
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,F2 | Nov 16, 2017 | G | 325,000 | $0.00 | D | 3,406,635 | D | |
| Common StockF2,F3 | holding | — | — | — | 2,882 | I | By Family Trust | |
| Common StockF2,F4 | holding | — | — | — | 454,733 | I | By GRAT | |
| Common StockF2,F5 | holding | — | — | — | 454,733 | I | By Wife GRAT | |
| Common StockF6 | holding | — | — | — | 3,237 | I | By Child Trust | |
| Common StockF7 | holding | — | — | — | 3,237 | I | By Child Trust | |
| Common StockF8 | holding | — | — | — | 3,237 | I | By Child Trust |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1The Form 5 filed on February 13, 2018 incorrectly reported the number of shares gifted by the reporting person on November 16,2017, and reported erroneous gifts to the Annuity Trusts for the benefit of the reporting person and his spouse.
- F2The number of derivative securities reported in column 5 reflects the number of shares held by the reporting person as of the filing date of this Form 5A and gives effect to all other amendments filed by the reporting person as of the date hereof.
- F3These shares are held directly by the SMSEJ Family Trust U/A dated July 18, 2005 of which Mr. Boal is a co-trustee.
- F4These shares are held directly by Steven R. Boal TTEE of the Steven R. Boal Annuity Trust dated December 6, 2013.
- F5These shares are held directly by Steven R. Boal TTEE of the Michele L. Boal Annuity Trust dated December 6, 2013.
- F6These shares are held directly by Stuart Shiff TTEE of the EBB 2011 Trust dated September 23, 2011.
- F7These shares are held directly by Stuart Shiff TTEE of the JMB 2011 Trust dated September 23, 2011.
- F8These shares are held directly by Stuart Shiff TTEE of the SEB 2011 Trust dated September 23, 2011.