SEC Form 4 · accession 0000914190-17-000348
TILE SHOP HOLDINGS, INC. · TTS
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Joyce Maruniak
Officer — Sr. VP - Supply Chain
Period of report
Nov 2, 2017
Accepted (ET)
Nov 6, 2017 · 4:35 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,F2 | Nov 2, 2017 | A | 11,650 | $0.00 | A | 31,650 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock Option (Right to Buy)F3 | $17.90 | holding | — | — | — | — | Mar 6, 2024 | Common Stock | 40,000 | 40,000 | D |
Explanation of responses
- F1Represents 11,650 shares of restricted stock for which the risks of forfeiture will lapse in installments of 2,912 shares on each of November 2, 2018 and November 2, 2019 and 2,913 shares on each of November 2, 2020 and November 2, 2021.
- F2Includes (i) 20,000 shares of restricted stock for which the Company's purchase option will lapse in equal installments of 4,000 shares on each of March 6, 2018, March 6, 2019, March 6, 2020, March 6, 2021 and March 6, 2022; and (ii) 11,650 shares of restricted stock for which the risks of forfeiture will lapse in installments of 2,912 shares on each of November 2, 2018 and November 2, 2019 and 2,913 shares on each of November 2, 2020 and November 2, 2021.
- F3Options to purchase 8,000 shares vest on each of March 6, 2018, March 6, 2019, March 6, 2020, March 6, 2021 and March 6, 2022.