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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. | SEC 1474 (9-02) |
1. Title of Derivative Security (Instr. 3) |
2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) |
5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4, and 5) |
6. Date Exercisable and Expiration Date (Month/Day/Year) |
7. Title and Amount of Underlying Securities (Instr. 3 and 4) |
8. Price of Derivative Security (Instr. 5) |
9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) |
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Non-Employee Director Option (Right to Buy) | $ 0.48 | 06/20/2019 | A | 156,540 (8) | (8) | 06/20/2029 | Common Stock | 156,540 (8) | (8) | 156,540 (8) | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
KOSKI ROBERT C 4902 EISENHOWER BOULEVARD TAMPA, FL 33634 |
X | |||
KOSKI CHRISTINE L 4902 EISENHOWER BOULEVARD TAMPA, FL 33634 |
Affiliate | |||
KOSKI BEVERLY 4902 EISENHOWER BOULEVARD TAMPA, FL 33634 |
Affiliate | |||
KOSKI FAMILY LP 4902 EISENHOWER BOULEVARD TAMPA, FL 33634 |
Affiliate | |||
KOSKI THOMAS L 4902 EISENHOWER BOULEVARD TAMPA, FL 33634 |
Affiliate |
/s/ Mark A. Catchur, as Attorney-in-Fact for ROBERT C. KOSKI CHRISTINE L. KOSKI, BEVERLY KOSKI, KOSKI FAMILY LIMITED PARTNERSHIP, AND THOMAS L. KOSKI | 06/24/2019 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 4(b)(v). |
** | Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
(1) | Shares owned directly by Robert C. Koski, a director of the Company. |
(2) | Shares owned directly by Koski Family Limited Partnership ("KFLP"). Shares owned indirectly by the KFLP general partners: Koski Management, Inc. (solely owned by Beverly Koski), Christine L. Koski, Robert C. Koski and Thomas L. Koski, each of whom is a general partner of the partnership or the controlling person of a corporate general partner of the partnership. |
(3) | Each reporting person disclaims beneficial ownership of all indirectly owned securities in excess of such reporting person's pecuniary interest therein, and this report shall not be deemed an admission that the reporting person is the beneficial owner for purposes of Section 16 or any other purpose. |
(4) | Shares owned directly by Christine L. Koski. |
(5) | Shares owned directly by Thomas L. Koski. |
(6) | Shares owned indirectly by Beverly Koski (through Koski Management, Inc.). |
(7) | Shares owned by trusts of which Mr. Robert C. Koski is sole trustee. Such trusts are as follows: the Robert Clayton Koski Trust for the benefit of Anthony James Hunter (10,760 shares); the Robert Clayton Koski Trust for the benefit of Hunter Buchanan Koski (10,760 shares); the Robert Clayton Koski Trust for the benefit of Clayton Ward Bennett (10,000 shares); the Robert Clayton Koski Trust for the benefit of Robert Edward Koski (10,760 shares); and the Robert Clayton Koski Trust for the benefit of Elyse Margaux Koski (10,806 shares). Mr. Koski disclaims beneficial ownership of the shares held by the trusts except to the extent of any pecuniary interest. |
(8) | Represents an award of options to purchase shares of the Company's common stock under the Company's 2012 Equity Incentive Plan in connection with service to the Company as a non-employee director. The option exercise price is the closing price on the date of the grant, June 20, 2019 (the "Grant Date"). The options vest quarterly in even amounts over the four quarters following the Grant Date. |