SEC Form 4 · accession 0000914760-16-000459
Del Taco Restaurants, Inc. · TACO
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Ari B. Levy
Director · 10% Owner
Period of report
Aug 8, 2016
Accepted (ET)
Aug 10, 2016 · 9:02 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001585583
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | Aug 8, 2016 | A | 184,870 | $0.00 | A | 2,501,329 | I | See Footnote |
| Common Stock | holding | — | — | — | 10,616 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Private Placement WarrantsF1,F2 | $11.50 | Aug 8, 2016 | D | 665,000 | D | — | — | Common Stock | 665,000 | 1,104,652 | I |
Explanation of responses
- F1The Reporting Person exchanged 665,000 warrants to purchase Common Stock for 184,870 shares of Common Stock in an exchange offer conducted by the Issuer. The Reporting Person disclaims beneficial ownership of the securities listed as indirectly owned by the Reporting Person except to the extent of his pecuniary interest therein. The transactions reported in this Form 4 are exempt under Rule 16b-3.
- F2The warrants became exercisable on July 30, 2015 and will expire on June 30, 2020 or earlier upon certain events.