SEC Form 5 · accession 0000914190-16-000533
TILE SHOP HOLDINGS, INC. · TTS
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Robert A Rucker
Director · 10% Owner
Period of report
Dec 31, 2015
Accepted (ET)
Feb 9, 2016 · 5:15 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001552800
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | Feb 19, 2015 | G | 471,822 | $0.00 | D | 5,802,428 | I | By The Tile Shop, Inc. |
| Common StockF2 | holding | — | — | — | 257,205 | D |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1These securities are owned by The Tile Shop, Inc. ("TTS"). The reporting person is the sole director of TTS.
- F2Includes 7,205 shares of restricted stock granted pursuant to the Company's 2012 Omnibus Award Plan (previously reported), which are subject to a purchase option in favor of the Company until August 21, 2016.