SEC Form 4 · accession 0001140361-17-014472
HEALTHEQUITY, INC. · HQY
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Adrian T Dillon
Director
Period of report
Mar 30, 2017
Accepted (ET)
Apr 3, 2017 · 9:10 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001428336
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1,F2 | Mar 30, 2017 | P | 5,000 | $40.5273 | A | 10,691 | D |
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)F3 | $46.40 | holding | — | — | — | — | Feb 1, 2027 | Common Stock | 4,837 | 4,837 | D |
| Stock Option (right to buy)F4 | $32.50 | holding | — | — | — | — | Sep 1, 2026 | Common Stock | 7,632 | 7,632 | D |
Explanation of responses
- F1The price reported in Column 4 is a weighted average price. These shares were purchased in multiple transactions at prices ranging from $40.5175 to $40.5397, inclusive. The reporting person undertakes to provide to the issuer, any security holder of the issuer, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares purchased at each separate price within the range set forth in this footnote (1) to this Form 4.
- F2Includes 4,963 shares underlying restricted stock units previously reported in Table II.
- F3The option becomes exercisable as to 2,418 shares on the date of the issuer's annual stockholder meeting, if any, held in the current fiscal year; the remainder will become exercisable on January 31, 2018.
- F4The option becomes exercisable in three equal annual installments of 2,544 shares on September 1, 2017, 2018, and 2019.
Remarks
The Power of Attorney given by Mr. Dillon was previously filed with the U.S. Securities & Exchange Commission on September 6, 2016 as an exhibit to a statement on Form 3 filed by Mr. Dillon with respect to HealthEquity, Inc. and is hereby incorporated by reference.