SEC Form 4 · accession 0001209191-15-077907
BLACKHAWK NETWORK HOLDINGS, INC · HAWK
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Jerry N Ulrich
Officer — CFO & Chief Admin Officer
Period of report
Oct 29, 2015
Accepted (ET)
Nov 2, 2015 · 7:19 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001411488
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock | Oct 29, 2015 | M | 25,000 | $9.15 | A | 50,490 | D | |
| Common StockF1,F2 | Oct 29, 2015 | S | 25,000 | $42.5527 | D | 25,490 | D | |
| Common StockF3 | holding | — | — | — | 6,000 | I | See Footnote |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock Option (Right to Buy)F4 | $9.151 | Oct 29, 2015 | M | 25,000 | D | — | May 5, 2016 | Common Stock | 25,000 | 0 | D |
Explanation of responses
- F1Transaction executed in multiple trades at prices ranging from $42.53 to $42.66 per share, inclusive. The price reported in column 4 of Table I above reflects the weighted average sale price per share. The Reporting Person hereby undertakes to provide the SEC staff, the Issuer or a security holder of the Issuer, upon request, full information regarding the number of shares sold at each respective price within the range set forth in this footnote.
- F2Includes 477 shares acquired under the Blackhawk Network Holdings, Inc. 2013 Employee Stock Purchase Plan ("ESPP") on April 30, 2015. The ESPP shares were acquired in transactions exempt from Section 16(b).
- F3The shares are held by The Ulrich Family Trust Dated November 1, 1996 as Amended and Restated in 2011.
- F4The shares vest pursuant to the following schedule: Twenty Percent (20%) of the shares subject to the option vest on each of the first, second, third, fourth and fifth anniversary of May 5, 2009, subject to the Reporting Person's continued employment or service relationship with the Issuer on each such vesting date.