SEC Form 4 · accession 0000914190-17-000336

TILE SHOP HOLDINGS, INC. · TTS

Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗

Reporting owner

Officer — Chief Financial Officer

Period of report

Oct 20, 2017

Accepted (ET)

Oct 24, 2017 · 4:04 pm EDT

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 Stock^F1	Oct 20, 2017	P	5,000	$8.745	A	17,070	D
Common Stock^F1	Oct 23, 2017	P	5,000	$9.245	A	22,070	D

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	Owned after	D/I
Stock Option (Right to Buy)^F2	$10.93	holding	—	—	—	—	Aug 12, 2021	Common Stock	100,000	100,000	D
Stock Option (Right to Buy)^F3	$18.15	holding	—	—	—	—	Apr 20, 2026	Common Stock	12,500	12,500	D
Stock Option (Right to Buy)^F4	$20.35	holding	—	—	—	—	May 11, 2027	Common Stock	13,200	13,200	D

F1Includes (i) 5,200 shares of restricted stock for which the Company's purchase option will lapse in equal installments of 1,300 shares on each of April 20, 2018, April 20, 2019, April 20, 2020 and April 20, 2021; (ii) 3,000 shares of restricted stock for which the Company's purchase option will lapse in installments of 750 shares on each of May 11, 2018, May 11, 2019, May 11, 2020 and May 11, 2021; and (iii) 3,000 shares of performance-based restricted stock for which the Company's purchase option will lapse on May 11, 2020 based on the Company's achievement of its three-year adjusted EBITDA target.
F2Options to purchase 20,000 shares vest on each of August 12, 2015, August 12, 2016, August 12, 2017, August 12, 2018 and August 12, 2019.
F3Options to purchase 2,500 shares vest on each of April 20, 2017, April 20, 2018, April 20, 2019, April 20, 2020 and April 20, 2021.
F4Options to purchase 3,300 shares vest on each of May 11, 2018, May 11, 2019, May 11, 2020 and May 11, 2021.