SEC Form 5 · accession 0001683168-17-000353
Lifeway Foods, Inc. · LWAY
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Julie Smolyansky
Officer — President and CEO · Director
Period of report
Dec 31, 2016
Accepted (ET)
Feb 14, 2017 · 4:26 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000814586
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock, no par valueF1 | Dec 30, 2016 | G | 1,200 | $0.00 | A | 16,920 | I | See Footnote |
| Common Stock, no par value | holding | — | — | — | 499,262 | D | ||
| Common Stock, no par valueF2 | holding | — | — | — | 2,886 | I | See Footnote | |
| Common Stock, no par valueF3 | holding | — | — | — | 500,000 | 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Performance Shares | $0.00 | Nov 17, 2016 | J | 9,407 | D | Aug 17, 2017 | Aug 17, 2017 | Common Stock | 9,407 | 0 | D |
Explanation of responses
- F1Held for the benefit of minor children.
- F2Held by the Reporting Person's spouse.
- F3The reporting person is the beneficial owner of 50% of Smolyansky Family Holdings, LLC and disclaims beneficial ownership of such shares except to the extent of any pecuniary interest therein.
- F4The grant of Performance Shares, which provided for vesting on August 17, 2017, was cancelled and extinguished pursuant to resolutions adopted by the Board of Directors' Compensation Committee in exchange for a cash payment in the amount of the original value of the performance share award.