SEC Form 4 · accession 0001562762-19-000038
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
Feb 15, 2019
Accepted (ET)
Feb 19, 2019 · 5:48 pm EST
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 | Feb 15, 2019 | A | 663,468 | — | A | 663,468 | I | By Corporation |
| Common StockF3 | holding | — | — | — | 113,443 | I | See Footnote | |
| Common StockF4 | holding | — | — | — | 24,419 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Exchangeable SharesF5,F6,F3 | — | Feb 15, 2019 | D | 221,156 | D | — | — | Common Stock | 663,468 | 0 | I |
Explanation of responses
- F1Cemblend Systems Inc. ("Cemblend") converted exchangeable shares into shares of common stock of the Issuer and distributed such shares to Stromquist Technologies Inc. ("STI").
- F2Held by STI, a corporation of which the Reporting Person is a controlling shareholder. The Reporting Person disclaims beneficial ownership of the Issuer's securities held by STI except to the extent of his pecuniary interest therein.
- F3Held by Cemblend. Cemblend is indirectly 50% owned by the Reporting Person. The Reporting Person disclaims beneficial ownership of the Issuer's securities held by Cemblend except to the extent of his pecuniary interest therein.
- F4Includes 24,419 restricted stock units which vest in three equal annual installments beginning on March 1, 2019.
- F5Represents exchangeable shares in NCS Multistage Inc., a wholly owned indirect subsidiary of the Issuer. 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.
- F6Not applicable.