Download Free Print-Only PDF OR Purchase Interactive PDF Version of this Form
Form 4 Statement Of Changes Of Beneficial Ownership Of Securities Instructions (SEC1475) Form. This is a Official Federal Forms form and can be use in Securities And Exchange Commission.
Tags: Form 4 Statement Of Changes Of Beneficial Ownership Of Securities Instructions (SEC1475), 4, Official Federal Forms Securities And Exchange Commission,
1 UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, DC 20549 FORM 4 STATEMENT OF CHANGES OF BENEFICIAL OWNERSHIP OF SECURITIES The Commission is authorized to solicit the information required by this Form pursuant to Sections 16(a) and 23(a) of the Securities Exchange Act of 1934, Sections 17(a) and 20(a) of the Public Utility Holding Company Act of 1935, and Sections 30(h) and 38 of the Investment Company Act of 1940, and the rules and regulations thereunder. Disclosure of information speci336 ed on this Form is mandatory, except for disclosure of the I.R.S. identi336 -cation number of the reporting person if such person is an entity, which is voluntary. If such numbers are furnished, they will assist the Commission in distinguishing reporting persons with similar names and will facilitate the prompt processing of the Form. The information will be used for the primary purpose of dis-closing the transactions and holdings of directors, of336cers, and bene336cial owners of registered companies. Information disclosed will be a matter of public record and available for inspection by members of the public. The Commission can use it in investigations or litigation involving the federal securities laws or other civil, criminal, or regulatory statutes or provisions, as well as for referral to other governmental authorities and self-regulatory organizations. Failure to disclose required information may result in civil or criminal action against persons involved for violations of the Federal securities laws and rules. GENERAL INSTRUCTIONS 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. SEC1475 (05-19) American LegalNet, Inc. www.FormsWorkFlow.com 1. When Form Must Be Filed (a) This Form must be 336led before the end of the second business day following the day on which a transaction resulting in a change in bene336cial ownership has been executed (see Rule 16a-1(a)(2) and Instruction 4 regarding the meaning of 223bene336cial owner,224 and Rule 16a-3(g) regarding determination of the date of execution for speci336ed transactions). This Form and any amendment is deemed 336led with the Commission or the Exchange on the date it is received by the Commission or the Exchange, respectively. See, however, Rule 16a-3(h) regarding delivery to a third party business that guarantees delivery of the 336ling no later than the speci336ed due date. (b) A reporting person no longer subject to Section 16 of the Securities Exchange Act of 1934 (223Exchange Act224) must check the exit box appearing on this Form. However, Form 4 and 5 obligations may continue to be applicable. See Rule 16a-3 (f); see also Rule 16a-2(b) (transactions after termination of insider status). Form 5 transactions to date may be included on this Form and subsequent Form 5 transactions may be reported on a later Form 4 or Form 5, provided all transactions are reported by the required date. (c) A separate Form shall be 336led to re337 ect bene336cial ownership of securities of each issuer, except that a single statement shall be 336led with respect to the securities of a registered public utility holding company and all of its subsidiary companies. (d) If a reporting person is not an of336cer, director, or ten percent holder, the person should check 223other224 in Item 6 (Relationship of Reporting Person to Issuer) and describe the reason for reporting status in the space provided. 2. Where Form Must be Filed (a) A reporting person must 336le this Form in electronic format via the Commission222s Electronic Data Gathering Analysis and Retrieval System (EDGAR) in accordance with EDGAR rules set forth in Regulation S-T (17 CFR Part 232), except that a 336ling person that has obtained a hardship exception under Regulation S-T Rule 202 (17 CFR 232.202) may 336le the Form in paper. For assistance with technical questions about EDGAR or to request an access code, call the EDGAR Filer Support Of336ce at (202) 942-8900. For assistance with questions about the EDGAR rules, call the Of336ce of EDGAR and Information Analysis at (202) 942-2940. (b) At the time this Form or any amendment is 336led with the Commission, 336le one copy with each Exchange on which any class of securities of the issuer is registered. If the issuer has designated a single Exchange to receive Section 16 336 lings, the copy shall be 336led with that Exchange only. (c) [Removed and Reserved] 3. Class of Securities Reported (a) (i) Persons reporting pursuant to Section 16(a) of the Exchange Act must report each transaction resulting in a change in bene336cial ownership of any class of equity securities of the issuer and the bene336cial ownership of that class of securities following the reported transaction(s), even though one or more of such classes may not be registered pursuant to Section 12 of the Exchange Act. (ii) Persons reporting pursuant to Section 17(a) of the Public Utility Holding Company Act of 1935 must report each transaction resulting in a change in bene336cial ownership of any class of securities (equity or debt) of the registered holding company and all of its subsidiary companies and the bene336cial ownership of that class of securities following the reported transaction(s). Specify the name of the parent or subsidiary issuing thesecurities. (iii) Persons reporting pursuant to Section 30(h) of the Investment Company Act of 1940 must report each transaction resulting in a change in bene336cial ownership of any class of securities (equity or debt) of the registered closed- end investment company (other than 223short-term paper224 as de336ned in Section 2(a)(38) of the Investment Company Act) and the bene336cial ownership of that class of securities following the reported transaction(s). (b) The title of the security should clearly identify the class, even if the issuer has only one class of securities outstanding; for example, 223Common Stock,224 223Class A Common Stock,224 223Class B Convertible Preferred Stock,224 etc. (c) The amount of securities bene336cially owned should state the face amount of debt securities (U.S. Dollars) or the number of equity securities, whichever is appropriate.2 American LegalNet, Inc. www.FormsWorkFlow.com 4. Transactions and Holdings Required To Be Reported (a) General Requirements (i) Report, in accordance with Rule 16a-3(g): (1) all transactions not exempt from 24716(b); (2) all transactions exempt from Section 16(b) pursuant to 247240.16b-3(d), 247240.16b-3(e), or 247240.16b-3(f); and (3) all exercises and conversions of derivative securities, regardless of whether exempt from Section 16(b) of the Act. Every transaction must be reported even though acquisitions and dispositions are equal. Report total bene336 cial ownership following the reported transaction(s) for each class of securities in which a transaction was reported. Note: The amount of securities bene336cially owned following the reported transaction(s) speci336ed in Column 5 of Table I and Column 9 of Table II should re337ect those holdings reported or required to be reported by the date of theForm. Transactions and holdings eligible for deferred reporting on Form 5 need not be re337ected in the month end total unless the transactions were reported earlier or are included on this Form. (ii) Each transaction should be reported on a separate line. Transaction codes speci336ed in Item 8 should be used to identify the nature of the transaction resulting in an acquisition or disposition of a security. A deemed execution date must be reported in Column 2A of Table I or Column 3A of Table II only if the execution date for the transaction is calculated pursuant to 247240.16a-3(g)(2) or 247240.16a-3(g)(3). Note: Transactions r eportable on Form 5 may, at the option of the reporting person, be reported on a Form 4 336 led before the due date of the Form 5. (See Instruction 8 for the code for voluntarily reported transactions.) (b) Bene336 cial Ownership Reported (Pecuniary Interest) (i) Although for purposes of determining status as a ten percent holder, a person is deemed to bene336cially own securitie