Statement of Changes in Beneficial Ownership (4)
June 02 2020 - 6:54PM
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
*
FIRST MARK L |
2. Issuer Name and Ticker or Trading Symbol
PetIQ, Inc.
[
PETQ
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director _____ 10% Owner _____ Officer (give title below) _____ Other (specify below) Non-Employee Director |
(Last)
(First)
(Middle)
437 MADISON AVE |
3. Date of Earliest Transaction
(MM/DD/YYYY)
5/29/2020 |
(Street)
NEW YORK, NY 10022
(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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Class A Common Stock | 5/29/2020 | | M(1) | | 747 | A | $30.68 | 1792 | D | |
Class A Common Stock | | | | | | | | 3472687 | I | See footnote (2) |
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 |
Restricted Stock Unit | (3) | 5/29/2020 | | M | | | 747 | (4) | (5) | Class A Common Stock | 747 | $30.68 | 0 | D | |
Explanation of Responses: |
(1) | Settlement of restricted stock units ("RSU") into shares of Class A common stock. |
(2) | Includes 2,922,844 shares of Class A Common Stock held by ECP Helios and 549,843 shares of Class A common Stock held by Eos Partners. Each of the Eos Funds is managed by Eos Management. Mr. First is managing director of Eos Management and has voting and investment control over and may be considered the beneficial owner of the Class A Common stock owned by the Eos Funds. Mr. First disclaims beneficial ownership of such securities and this report shall not be deemed an admission that Mr. First is the beneficial owner of the securities for purposes of Section 16 or for any other purpose, except to the extent of his pecuniary interest therein. |
(3) | Each RSU represents a contingent right to receive one share of Class A Common Stock. |
(4) | No exercisable date for this type of award |
(5) | No Expiration date for this type of award |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
FIRST MARK L 437 MADISON AVE NEW YORK, NY 10022 | X |
| Non-Employee Director |
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Signatures
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/s/ R. Michael Herrman, as attorney-in-fact | | 6/2/2020 |
**Signature of Reporting Person | Date |
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