SEC Form 4 · accession 0001209191-17-014760
HSN, Inc. · HSNI
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Mindy F Grossman
Officer — CEO · Director
Period of report
Feb 23, 2017
Accepted (ET)
Feb 27, 2017 · 4:26 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001434729
Table I — non-derivative securities
No Table I lines on this filing.
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock Appreciation RightsF1,F2 | $38.80 | Feb 23, 2017 | A | 253,394 | A | — | Feb 23, 2027 | Common Stock, par value $0.01 per share. | 253,394 | 253,394 | D |
| Restricted Stock UnitsF3,F4 | — | Feb 23, 2017 | A | 21,650 | A | — | — | Common Stock, par value $0.01 per share. | 21,650 | 54,588 | D |
Explanation of responses
- F1The stock appreciation right will vest ratably over three years beginning on February 23, 2018 in three approximately equal installments, and has a ten-year term.
- F2The stock appreciation right has an appreciation cap of 200%. As a result, the maximum number of shares deliverable for each stock appreciation right is two-thirds of a share of stock per stock appreciation right.
- F3Each Restricted Stock Unit represents a right to receive one share of HSN, Inc. common stock.
- F4All of such Restricted Stock Units vest on February 23, 2020. Shares of Common Stock will be delivered on a one-for-one basis.