SEC Form 4 · accession 0000899243-19-006465
Select Interior Concepts, Inc. · SIC
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Sunil Palakodati
Officer — President-ASG
Period of report
Mar 4, 2019
Accepted (ET)
Mar 6, 2019 · 5:00 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001723866
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Class A Common StockF1,F2 | Mar 4, 2019 | D | 76,844 | $0.00 | D | 173,465 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Phantom StockF3 | — | Mar 4, 2019 | D | 76,844 | D | — | — | Class A Common Stock | — | 0 | D |
| Restricted Stock UnitsF4 | — | Mar 4, 2019 | A | 24,222 | A | — | — | Class A Common Stock | 24,222 | 24,222 | D |
Explanation of responses
- F1These shares of Class A Common Stock, which were granted by the Issuer to the Reporting Person under the Issuer's 2017 Incentive Compensation Plan on November 22, 2017, were forfeited on March 4, 2019 due to the non-achievement of certain performance goals of the Issuer.
- F219,211 shares of the Class A Common Stock held by the Reporting Person were granted by the Issuer to the Reporting Person under the Issuer's 2017 Incentive Compensation Plan on November 22, 2017, and are subject to vesting over three years in nearly equal annual installments beginning on the first anniversary of the grant date, provided that the Reporting Person remains in the service of the Issuer through the applicable vesting date.
- F3The phantom stock, which were granted by the Issuer to the Reporting Person under the Issuer's 2017 Incentive Compensation Plan on November 22, 2017, were forfeited on March 4, 2019 due to the non-achievement of certain performance goals of the Issuer.
- F4These restricted stock units were granted by the Issuer to the Reporting Person under the Issuer's 2017 Incentive Compensation Plan on March 4, 2019, and are subject to vesting over three years in nearly equal annual installments beginning on the first anniversary of the grant date, provided that the Reporting Person remains in the service of the Issuer through the applicable vesting date. Each restricted stock unit represents a contingent right to receive one share of the Issuer's Class A Common Stock.