SEC Form 4/A · accession 0001209191-18-019974
TRIPLE-S MANAGEMENT CORP · GTS
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
This is an amendment (Form 4/A). It replaces an earlier filing for the same period.
Reporting owner
Madeline Hernandez-Urquiza
Officer — President of TSS and TSAS
Period of report
Mar 6, 2018
Accepted (ET)
Mar 15, 2018 · 7:11 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001171662
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Class B Common StockF1 | Mar 6, 2018 | A | 7,807 | $0.00 | A | 40,211 | D | |
| Class B Common StockF2,F3 | Mar 6, 2018 | A | 14,980 | $0.00 | A | 55,191 | D |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1Shares acquired represent grant of restricted stock that will vest in equal installments on each of March 6, 2019, 2020 and 2021.
- F2Shares acquired represent common stock earned pursuant to a grant of Performance Shares on March 3, 2015. The Performance Shares resulting in the issuance of these shares of common stock did not constitute derivative securities. As a result, such Performance Shares were not required to be reported and were not reported on a Form 4 at the time of the award.
- F3On March 8, 2018, the reporting person mistakenly filed a Form 4 reporting the acquisition of 4,787 shares of Class B Common Stock when in fact she acquired the number of shares specified in this Form.
Remarks
Ms. Hernandez-Urquiza is President and CEO of Triple-S Salud, Inc. ("TSS") and Triple-S Advantage Solutions, Inc. ("TSAS").