SEC Form 4 · accession 0001209191-16-146734

BLACKHAWK NETWORK HOLDINGS, INC · HAWK

Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗

Reporting owner

David C Tate

Officer — SVP, U.S. Retail

Period of report

Oct 20, 2016

Accepted (ET)

Oct 24, 2016 · 4:33 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
Common Stock	Oct 20, 2016	M	2,500	$21.031	A	22,372	D
Common Stock	Oct 20, 2016	M	13,076	$26.73	A	35,448	D
Common Stock	Oct 20, 2016	M	6,875	$20.00	A	42,323	D
Common Stock^F1	Oct 20, 2016	S	22,451	$36.3983	D	19,872	D
Common Stock^F2	Oct 20, 2016	S	5,863	$36.5051	D	14,009	D

Table II — derivative securities

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	Owned after	D/I
Employee Stock Option (Right to Buy)^F3	$21.031	Oct 20, 2016	M	2,500	D	—	Oct 18, 2018	Common Stock	2,500	0	D
Employee Stock Option (Right to Buy)^F4	$26.73	Oct 20, 2016	M	13,076	D	—	Mar 12, 2021	Common Stock	13,076	13,074	D
Employee Stock Option (Right to Buy)^F5	$20.00	Oct 20, 2016	M	6,875	D	—	Mar 26, 2020	Common Stock	6,875	6,875	D

Explanation of responses

F1Transaction executed in multiple trades at prices ranging from $36.325 to $36.50 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.
F2Transaction executed in multiple trades at prices ranging from $36.50 to $36.5075 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.
F3The shares subject to the option vest pursuant to the following schedule: Twenty Percent (20%) of the shares subject to the option vest in five equal annual installments starting on March 14, 2012, subject to the Reporting Person's ontinued employment or service relationship with the Company on each such vesting date.
F4The shares subject to the option 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 March 12, 2014, subject to the Reporting Person's continued employment or service relationship with the Company on each such vesting date.
F5The shares subject to the option 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 March 26, 2013, subject to the Reporting Person's continued employment or service relationship with the Company on each such vesting date.