SEC Form 4 · accession 0001144204-15-052122
JAMBA, INC. · JMBA
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Dale Goss
Officer — SVP Store Development
Period of report
Aug 24, 2015
Accepted (ET)
Aug 26, 2015 · 7:50 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001316898
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1,F2 | Aug 24, 2015 | M | 666 | $0.00 | A | 15,269 | D | |
| Common StockF2 | Aug 24, 2015 | F | 179 | $13.28 | A | 15,090 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Restricted Stock UnitF1,F3 | — | Aug 24, 2015 | M | 666 | D | — | — | Common Stock | 666 | 666 | D |
Explanation of responses
- F1Represents shares of JMBA common stock upon settlement of restricted stock units.
- F2The number of securities reported in this column includes 10,099 restricted stock units held by the Reporting Person as of the date of this filing.
- F3The restricted stock units vest in three equal annual installments beginning on the vesting commencement date of August 22, 2012. Vested shares will be delivered to the Reporting Person on the first, second and third anniversary of the vesting commencement date.