SEC Form 4 · accession 0000904454-19-000036
Champion Homes, Inc. · SKY
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Timothy A. Burkhardt
Officer — Vice President and Controller
Period of report
Jan 3, 2019
Accepted (ET)
Jan 7, 2019 · 5:16 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000090896
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | Jan 3, 2019 | A | 5,000 | $0.00 | A | 56,003 | D | |
| Common StockF2 | Jan 3, 2019 | A | 5,833 | $0.00 | A | 61,836 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock Option (Right to Buy)F3 | $15.00 | Jan 3, 2019 | A | 5,833 | A | — | Jan 3, 2029 | Common Stock | 5,833 | 5,833 | D |
Explanation of responses
- F1Represents restricted stock units ("RSUs") granted to the Reporting Person under the Issuer's 2018 Equity Incentive Plan . Each RSU represents the contingent right to receive one share of Common Stock. Subject to the terms of the award agreement evidencing the grant of the RSUs, one-third of the RSUs vests on each of the first three anniversaries of July 1, 2018, provided that the Reporting Person remains in continuous service with the Issuer through each vesting date.
- F2Represents performance-based restricted stock units ("PRSUs") granted to the Reporting Person under the Issuer's 2018 Equity Incentive Plan. Each PRSU represents the contingent right to receive one share of Common Stock. Subject to the terms of the award agreement evidencing the grant of the PRSUs, vesting of a percentage of the PRSUs (including up to 150%) is dependent on the Issuer's total shareholder return from July 1, 2018 through July 1, 2021 relative to the total shareholder return of certain other companies over that same time period, provided that the Reporting Person remains in continuous service with the Issuer through each vesting date.
- F3The stock option will vest as to one-third of the shares subject to the stock option on each of July 1, 2019, July 1, 2020 and July 1, 2021, provided that the Reporting Person remains in continuous service with the Issuer through each vesting date.