SEC Form 4/A · accession 0001437749-16-032861
Natural Grocers by Vitamin Cottage, Inc. · NGVC
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | Dec 21, 2015 | G | 1,000 | $0.00 | D | 3,106,402 | D | |
| Common StockF1 | Dec 21, 2015 | G | 1,000 | $0.00 | A | 104,745 | I | By Anthony Andueza as UTMA custodian for son |
| Common StockF2 | Dec 21, 2015 | G | 1,000 | $0.00 | D | 3,105,402 | D | |
| Common StockF2 | Dec 21, 2015 | G | 1,000 | $0.00 | A | 104,745 | I | By Raquel M. Isely, the reporting person's daughter |
| Common StockF3 | holding | — | — | — | 6,716 | I | By KIVC 3,LLC | |
| Common StockF4 | holding | — | — | — | 616,254 | I | ZIVC,LLC | |
| Common StockF4 | holding | — | — | — | 201,856 | I | By HIVC 1, LLC | |
| Common StockF4 | holding | — | — | — | 478,788 | I | By HIVC 2, LLC | |
| Common StockF5 | holding | — | — | — | 571,850 | I | By FTVC, LLC |
Table II — derivative securities
Explanation of responses
- F1No price is entered because the transaction is an exempt bona fide gift of Common Stock to Anthony Andueza, as Custodian for Ritchie K. Isely, the Reporting Person's son, under the Colorado Uniform Transfers to Minors Act. The Reporting Person has no investment power over these shares and disclaims beneficial ownership of these shares.
- F2No price is entered because the transaction is an exempt bona fide gift of Common Stock to Raquel M. Isely, the Reporting Person's daughter, who shares the Reporting Person's household. The Reporting Person has no investment power over these shares and disclaims beneficial ownership of these shares
- F3The Reporting Person is a member, but has no investment power over these shares and disclaims beneficial ownership of these shares except to the extent of his pecuniary interest therein.
- F4The Reporting Person is a beneficiary through a member trust, but has no investment power over these shares and disclaims beneficial ownership of these shares except to the extent of his pecuniary interest therein.
- F5The Reporting Person is a beneficiary through a member trust and disclaims beneficial ownership of these shares except to the extent of his pecuniary interest therein.
Remarks
The Reporting Person is a party to a Stockholders Agreement entered into in connection with the initial public offering of the issuer's stock that contains voting agreements and thus is a member of a Schedule 13D group that beneficially owns more than 10% of the issuer's common stock. The number of shares identified as beneficially owned by the Reporting Person excludes shares of Common Stock deemed to be beneficially owned by him solely because of this Stockholders Agreement. The original Form 4 filed on December 21, 2015 is amended by this Form 4 amendment to correctly reflect the transaction and the Reporting Person's indirect ownership of Common Stock.