Statement of Changes in Beneficial Ownership (4)
February 09 2021 - 4:43PM
Edgar (US Regulatory)
FORM 4
[ ]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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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
*
MCRAE MATTHEW BLAKE |
2. Issuer Name and Ticker or Trading Symbol
Arlo Technologies, Inc.
[
ARLO
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director _____ 10% Owner __X__ Officer (give title below) _____ Other (specify below) CEO |
(Last)
(First)
(Middle)
3030 ORCHARD PARKWAY |
3. Date of Earliest Transaction
(MM/DD/YYYY)
2/5/2021 |
(Street)
SAN JOSE, CA 95134
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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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 Acquired, Disposed of, or Beneficially Owned
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1.Title of Security (Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code (Instr. 8)
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4. Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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Common Stock | 2/5/2021 | | A | | 274728 | A | $0.00 | 1495848 | D | |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Trans. Date | 3A. Deemed Execution Date, if any | 4. Trans. 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 | 7. Title and Amount of Securities Underlying Derivative Security (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) |
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Performance Restricted Stock Units (PSUs) | (1) | 2/5/2021 | | A |
V
| 137364 | | (2) | (2) | Common Stock | 137364 | $0.00 | 137364 | D | |
Performance Restricted Stock Units (PSUs) | (1) | 2/5/2021 | | A |
V
| 137364 | | (3) | (3) | Common Stock | 137364 | $0.00 | 137364 | D | |
Explanation of Responses: |
(1) | Each PSU represents a contingent right to receive one share of the Issuer's common stock. |
(2) | Each PSU represents a contingent right to receive shares of the Issuer's common stock, based upon the achievement of certain financial milestones. Subject to achievement of such milestones, each PSU will vest in four equal annual installments. The number of shares reported herein is a target number, however the actual number of shares issuable pursuant to the PSUs will not exceed 120% of the number of target shares. |
(3) | Each PSU represents a contingent right to receive shares of the Issuer's common stock, based upon total relative shareholder return during certain established performance periods over a period of four years. The number of shares reported herein is a target number, however the actual number of shares issuable pursuant to the PSUs will not exceed 200% of the number of target shares. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
MCRAE MATTHEW BLAKE 3030 ORCHARD PARKWAY SAN JOSE, CA 95134 | X |
| CEO |
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Signatures
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/s/ Brian M. Busse, Attorney-in-Fact | | 2/9/2021 |
**Signature of Reporting Person | Date |
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