SEC Form 4 · accession 0001209191-18-002770
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
Jan 4, 2018
Accepted (ET)
Jan 8, 2018 · 6:06 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 StockF1 | Jan 4, 2018 | M | 4,537 | $0.00 | A | 40,968 | D | |
| Common StockF2,F3 | Jan 4, 2018 | F | 1,885 | $36.00 | D | 39,083 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Performance Share Units (PSU)F5,F4 | — | Jan 4, 2018 | M | 4,537 | D | Jan 4, 2018 | Jan 4, 2018 | Common Stock | 4,537 | 0 | D |
Explanation of responses
- F1The Reporting Person acquired the shares upon settlement of the Performance Share Units certified on February 22, 2016.
- F2Shares tendered in payment of the tax withholding obligation.
- F3Represents the closing price of the common stock on the date of forfeiture.
- F4Represents the performance shares earned under the 2015 performance share award as of February 22, 2016, at which date the Compensation Committee certified the extent to which the 2015 performance criteria were met. Each earned performance share represents the contingent right to receive one share of the Issuer's common stock.
- F5Reflects a correction (due to rounding) in the number of performance share units earned upon satisfaction of the applicable performance criteria as certified by the Compensation Committee of the Issuer.