SEC Form 3 · accession 0001127602-16-047309
BON TON STORES INC · BONT
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Debra Kaufman Simon
Director
Period of report
Mar 18, 2016
Accepted (ET)
Mar 23, 2016 · 5:03 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000878079
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | holding | — | — | — | 890,945 | D | ||
| Common StockF1,F2 | holding | — | — | — | 1 | I | By 401(k) Plan | |
| Common StockF1 | holding | — | — | — | 292,307 | I | By IRA |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Class A Common StockF3,F1 | — | holding | — | — | — | — | — | Common Stock | 2,951,490 | — | D |
Explanation of responses
- F1The reporting person disclaims beneficial ownership of these securities, and this report shall not be deemed an admission that the reporting person is the beneficial owner of the securities for purposes of Section 16 or for any other purpose. Ms. Simon is the wife of Tim Grumbacher. The relevant securities reflected in Table I and Table II are owned by Tim Grumbacher and are reflected as beneficially owned by Ms. Simon pursuant to Rule 16a-1(a)(2)(ii)(A).
- F2These shares are held under The Bon-Ton Stores, Inc. Profit Sharing/Retirement Savings Plan.
- F3The Class A Common Stock is convertible into Common Stock at any time on a one-for-one basis.