SEC Form 4 · accession 0001140361-17-018475
NCS Multistage Holdings, Inc. · NCSM
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Marty Stromquist
Officer — President · Director
Period of report
May 3, 2017
Accepted (ET)
May 4, 2017 · 5:01 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001692427
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1,F2 | May 3, 2017 | A | 25,000 | — | A | 25,000 | I | See Footnote |
| Common StockF2 | May 3, 2017 | S | 25,000 | $15.94 | D | 0 | I | See Footnote |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Exchangeable SharesF1,F2 | — | May 3, 2017 | D | 8,333 | D | — | — | Common Stock | 25,000 | 294,875 | I |
Explanation of responses
- F1Represents exchangeable shares in NCS Multistage Inc., a wholly owned indirect subsidiary of the Issuer, that were exchanged for shares of common stock of the Issuer in connection with the Issuer's initial public offering. Each exchangeable share is convertible into three shares of common stock of the Issuer, subject to adjustment. The exchangeable shares are currently exercisable and have no expiration date.
- F2The shares are held by Cemblend Systems Inc. Cemblend Systems Inc. is indirectly 50% owned by Mr. Stromquist.