SEC Form 4 · accession 0001209191-16-128187
BLACKHAWK NETWORK HOLDINGS, INC · HAWK
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Sachin Dhawan
Officer — SVP, Chief Technology Officer
Period of report
Jun 14, 2016
Accepted (ET)
Jun 16, 2016 · 4:41 pm EDT
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 StockF1,F2 | Jun 14, 2016 | A | 100,000 | $0.00 | A | 100,000 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Non-qualified stock option (right to buy)F3 | $32.84 | Jun 14, 2016 | A | 50,000 | A | — | Jun 14, 2023 | Common Stock | 50,000 | 50,000 | D |
Explanation of responses
- F1Represents restricted stock units. Each restricted stock unit represents a right to receive one share of Blackhawk Network Holdings, Inc. common stock upon vesting.
- F2The restricted stock units vest pursuant to the following schedule: Twenty-Five Percent (25%) of the shares subject to the restricted stock unit vest on each of the first, second, third, and fourth anniversary of June 14, 2016, subject to the Reporting Person's continued employment or service relationship with the Company on each such vesting date.
- F3The shares vest pursuant to the following schedule: Twenty-Five Percent (25%) of the shares subject to the option vest on each of the first, second, third and fourth anniversary of June 14, 2016, subject to the Reporting Person's continued employment or service relationship with the Company on each such vesting date.