Amended Statement of Beneficial Ownership (3/a)
July 06 2016 - 5:47PM
Edgar (US Regulatory)
FORM 3
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0104
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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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1. Name and Address of Reporting Person
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CHUMBLEY BOYD BROOKS
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2. Date of Event Requiring Statement (MM/DD/YYYY)
1/20/2016
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3. Issuer Name
and
Ticker or Trading Symbol
CULP INC [CFI]
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(Last)
(First)
(Middle)
1823 EASTCHESTER DRIVE
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4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
_____ Director
_____ 10% Owner
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X
___ Officer (give title below)
_____ Other (specify below)
Executive VP Upholstery Fabric /
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(Street)
HIGH POINT, NC 27265
(City)
(State)
(Zip)
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5. If Amendment, Date Original Filed
(MM/DD/YYYY)
3/16/2016
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6. Individual or Joint/Group Filing
(Check Applicable Line)
_
X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Beneficially Owned
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1.Title of Security
(Instr. 4)
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2. Amount of Securities Beneficially Owned
(Instr. 4)
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3. Ownership Form: Direct (D) or Indirect (I)
(Instr. 5)
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4. Nature of Indirect Beneficial Ownership
(Instr. 5)
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Common Stock
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18236
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D
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Common Stock
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11018
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I
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401(k) Plan
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Table II - Derivative Securities Beneficially Owned (
e.g.
, puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security
(Instr. 4)
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2. Date Exercisable and Expiration Date
(MM/DD/YYYY)
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3. Title and Amount of Securities Underlying Derivative Security
(Instr. 4)
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4. Conversion or Exercise Price of Derivative Security
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5. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 5)
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6. Nature of Indirect Beneficial Ownership
(Instr. 5)
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Date Exercisable
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Expiration Date
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Title
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Amount or Number of Shares
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Incentive Stock Option (Right to Buy)
(1)
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6/25/2012
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6/25/2017
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Common Stock
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5000
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$8.75
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D
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Restricted Stock Units
(2)
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(3)
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(3)
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Common Stock
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11923
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$0
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D
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Restricted Stock Units
(2)
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(4)
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(4)
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Common Stock
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15838
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$0
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D
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Restricted Stock Units
(2)
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(5)
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(5)
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Common Stock
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10185
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$0
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D
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Explanation of Responses:
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(
1)
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Employee stock option (right to buy) granted pursuant to the Culp, Inc. 2007 Equity Incentive Plan in reliance upon exemption provided by Rule 16b-3(d).
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(
2)
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Contingent right to receive issuance of Culp Inc. common stock.
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(
3)
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These restricted stock units could earn up to 11,923 shares of common stock over a three year period from April 29, 2013 through May 1, 2016, if the company meets certain performance criteria as defined in the award agreement.
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(
4)
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These restricted stock units could earn up to 15,838 shares of common stock over a three year period from April 28, 2014 through April 30, 2017, if the company meets certain performance criteria as defined in the award agreement.
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(
5)
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The restricted stock units could earn up to 10,185 shares of common stock over a three year period from May 4, 2015 through April 29, 2018, if the company meets certain performance criteria as defined in the agreement.
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Reporting Owners
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Reporting Owner Name / Address
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Relationships
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Director
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10% Owner
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Officer
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Other
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CHUMBLEY BOYD BROOKS
1823 EASTCHESTER DRIVE
HIGH POINT, NC 27265
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Executive VP Upholstery Fabric
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Signatures
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/s/Kenneth R. Bowling, Attorney-In-Fact
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7/6/2016
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**
Signature of Reporting Person
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Date
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
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*
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If the form is filed by more than one reporting person,
see
Instruction 5(b)(v).
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**
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Intentional misstatements or omissions of facts constitute Federal Criminal Violations.
See
18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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Note:
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File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure.
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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.
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