SEC Form 4 · accession 0001620533-15-000092
Shake Shack Inc. · SHAK
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Jack R Polsky
10% Owner
Period of report
Aug 18, 2015
Accepted (ET)
Aug 20, 2015 · 6:30 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001620533
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| CLASS A COMMON STOCKF1,F2 | Aug 18, 2015 | C | 22,890 | $0.00 | A | 22,890 | I | BY TRUST |
| CLASS A COMMON STOCKF2 | Aug 18, 2015 | S | 22,890 | $57.75 | D | 0 | I | BY TRUST |
| CLASS B COMMON STOCKF3,F2 | Aug 18, 2015 | J | 22,890 | $0.00 | D | 146,878 | I | BY TRUST |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Common Membership InterestsF2,F4 | — | Aug 18, 2015 | C | 22,890 | D | — | — | CLASS A COMMON STOCK | 22,890 | 146,878 | I |
Explanation of responses
- F1Shares obtained upon redemption of common membership interests in SSE Holdings, LLC (the "LLC Interests") for an equal number of shares of the Issuer's Class A Common Stock.
- F2Held directly by the Roxanne Frank Revocable Trust, of which Jack Polsky (the "Reporting Person") is a trustee and Roxanne H. Frank is a co-trustee. The shares and LLC Interests reported herein are also reported on a Form 4 filed by Roxanne H. Frank and the Roxanne Frank Revocable Trust on August 20, 2015. The Reporting Person disclaims beneficial ownership of such shares and LLC Interests, as applicable, except to the extent of his pecuniary interest therein.
- F3Pursuant to the Amended and Restated Certificate of Incorporation of the Issuer, the shares of the Issuer's Class B Common Stock are cancelled for no consideration on a one-for-one basis upon redemption of the LLC Interests for shares of Class A Common Stock.
- F4Represents LLC Interests which are redeemable for an equal number of shares of the Issuer's Class A Common Stock or, at the election of the Issuer, cash equal to the volume-weighted average market price of such shares. The LLC Interests have no expiration date.