SEC Form 4 · accession 0001179110-16-029278
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
Sep 2, 2016
Accepted (ET)
Sep 2, 2016 · 5:09 pm EDT
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 StockF2 | Sep 2, 2016 | C | 100,000 | $0.00 | A | 1,691,651 | D | |
| Class A Common Stock | holding | — | — | — | 142,654 | I | By 401(k) Plan |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Class B Common StockF1,F3 | — | Sep 2, 2016 | C | 100,000 | D | — | — | Class A Common Stock | 900,000 | 200,000 | D |
Explanation of responses
- F1The Class B Common Stock is convertible into the Issuer's Class A Common Stock on a 1-for-2 basis at the holder's option and has no expiration date.
- F2Represents the number of shares that were acquired upon conversion of Class B Common Stock to Class A Common Stock.
- F3The holder elected to convert the shares of Class B Common Stock into Class A Common Stock on a 1-for-1 basis.