SEC Form 4 · accession 0001179110-16-017695
Liberty Tax, Inc. · TAXA
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
John T Hewitt
Officer — Chief Executive Officer/Pres. · Director · 10% Owner
Period of report
Jan 8, 2016
Accepted (ET)
Jan 12, 2016 · 5:06 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001528930
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Class A Common Stock | Jan 8, 2016 | M | 12,355 | $15.00 | A | 992,904 | D | |
| Class A Common StockF1 | Jan 8, 2016 | F | 10,193 | $21.05 | D | 982,711 | D | |
| Class A Common Stock | Jan 11, 2016 | M | 16,943 | $15.00 | A | 999,654 | D | |
| Class A Common StockF2 | Jan 11, 2016 | F | 13,903 | $20.81 | D | 985,751 | 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 Options (Right to Buy) | $15.00 | Jan 8, 2016 | M | 12,355 | D | Apr 15, 2011 | Apr 15, 2016 | Class A Common Stock | 68,940 | 56,585 | D |
| Employee Stock Option (Right to Buy) | $15.00 | Jan 11, 2016 | M | 16,943 | D | Apr 15, 2011 | Apr 15, 2016 | Class A Common Stock | 56,585 | 39,642 | D |
Explanation of responses
- F1Reflects 10,193 shares sold by a broker-dealer at an average market price of $21.05 per share less an exercise price of $15.00 per share to fund the exercise of 2,162 options owned by John T. Hewitt.
- F2Reflects 13,903 shares sold by a broker-dealer at an average market price of $20.81 per share less an exercise price of $15.00 per share to fund the exercise of 3,040 options owned by John T. Hewitt.