SEC Form 5 · accession 0001209191-15-009439
ARC DOCUMENT SOLUTIONS, INC. · ARC
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Thomas J Formolo
Director
Period of report
Dec 29, 2014
Accepted (ET)
Feb 4, 2015 · 4:43 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001305168
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | Dec 29, 2014 | G | 7,229 | $0.00 | D | 122,318 | D | |
| Common StockF2 | Dec 30, 2014 | G | 2,411 | $0.00 | D | 119,907 | D | |
| Common StockF3 | Dec 30, 2014 | G | 2,411 | $0.00 | A | 12,441 | I | By Andersen-Formolo Family Foundation - Q52455005 |
| Common StockF2 | Dec 30, 2014 | G | 20,000 | $0.00 | D | 99,907 | D | |
| Common StockF3 | Dec 30, 2014 | G | 20,000 | $0.00 | A | 32,441 | I | By Andersen-Formolo Family Foundation - Q52455005 |
| Common Stock | holding | — | — | — | 129,547 | D | ||
| Common StockF4 | holding | — | — | — | 12,740 | I | By Danish-Italian Investors, L.P., Series A |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1Bonafide gift of shares to Willow Creek Church
- F2Bonafide gift of shares to The Andersen-Formolo Family Foundation
- F3Thomas J. Formolo is the President of Andersen-Formolo Foundation - Q52455005. Mr. Formolo could be deemed to have a beneficial ownership of these shares but disclaims beneficial ownership.
- F4Thomas J. Formolo is a partner of Danish-Italian Investors, L.P., Series A. Mr. Formolo could be deemed to have beneficial ownership of all of these shares but disclaims beneficial ownership except to his pecuniary interest therein.