SEC Form 5 · accession 0001683168-17-000355
Lifeway Foods, Inc. · LWAY
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Edward Smolyansky
Officer — COO, Treasurer, and Secretary
Period of report
Dec 31, 2016
Accepted (ET)
Feb 14, 2017 · 4:41 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 value | Dec 30, 2016 | G | 1,200 | $0.00 | A | 262,715 | D | |
| Common Stock, no par value | Dec 30, 2016 | G | 6,008 | $0.00 | D | 256,707 | D | |
| Common Stock, no par valueF1 | 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
- F1The 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.
- F2The grant of Performance Shares, which provided for vesting on August 17, 2017, was cancelled, terminated and extinguished pursuant to resolutions adopted by the Company's Compensation Committee in exchange for a cash payment in the amount of the original value of the award.