SEC Form 4 · accession 0000914190-19-000083
TILE SHOP HOLDINGS, INC. · TTS
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Peter J Jacullo III
Director · 10% Owner
Period of report
Mar 4, 2019
Accepted (ET)
Mar 6, 2019 · 4:57 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 StockF3 | Mar 4, 2019 | P | 10,000 | $6.02 | A | 1,034,424 | I | By Irrevocable Trust |
| Common StockF3 | Mar 6, 2019 | P | 10,000 | $6.02 | A | 1,044,424 | I | By Irrevocable Trust |
| Common StockF1 | holding | — | — | — | 362,262 | D | ||
| Common StockF2 | holding | — | — | — | 4,441,180 | I | By JWTS, Inc. |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1Includes 12,669 shares of restricted stock granted pursuant to the Company's 2012 Omnibus Award Plan, which are subject to a risk of forfeiture until the earlier of (a) the date of the Company's next annual meeting of stockholders and (b) July 10, 2019.
- F2These securities are owned by JWTS, Inc. The reporting person is the sole director of JWTS, Inc. The reporting person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein, and this report shall not be deemed an admission that the reporting person is the beneficial owner of such securities for Section 16 or any other purpose.
- F3These securities are owned by the Katherine D. Jacullo Children's 1993 Irrevocable Trust. The reporting person is the trustee. The reporting person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein, and this report shall not be deemed an admission that the reporting person is the beneficial owner of such securities for Section 16 or any other purpose.