Statement of Changes in Beneficial Ownership (4)
October 19 2020 - 08:45AM
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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OMB
APPROVAL
OMB Number: 3235-0287
Estimated average burden
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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 * Trojanowski Amy |
2. Issuer Name and Ticker or Trading
Symbol Armstrong Flooring, Inc. [ AFI ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)_____
Director _____
10% Owner
__X__ Officer (give title
below) _____ Other
(specify below)
SVP, CFO |
(Last)
(First)
(Middle)
C/O ARMSTRONG FLOORING, INC., 2500 COLUMBIA AVE. PO BOX
3025 |
3. Date of Earliest Transaction (MM/DD/YYYY)
10/19/2020
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(Street)
LANCASTER, PA 17603
(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 |
Table I - Non-Derivative Securities Acquired, Disposed of, or
Beneficially Owned
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1.Title of Security
(Instr. 3) |
2. Trans. Date |
2A. Deemed Execution Date, if any |
3. Trans. Code
(Instr. 8) |
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5) |
5. Amount of Securities Beneficially Owned Following
Reported Transaction(s)
(Instr. 3 and 4) |
6. Ownership Form: Direct (D) or Indirect (I)
(Instr. 4) |
7. Nature of Indirect Beneficial Ownership (Instr.
4) |
Code |
V |
Amount |
(A) or (D) |
Price |
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 |
(1) |
10/19/2020 |
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A |
|
100000 |
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(2) |
(2) |
Common Stock |
100000 |
$0.00 |
100000 |
D |
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Explanation of
Responses: |
(1) |
Each restricted stock unit
represents a contingent right to receive one share of the Issuer's
common stock under the Issuer's 2016 Long-Term Incentive Plan, as
amended and restated. |
(2) |
The restricted stock units
were granted on October 19, 2020 ("Grant Date") and will vest in
equal installments on each of the five (5) successive anniversaries
of the Grant Date (contingent upon the Reporting Person's
employment with the Issuer on the scheduled vesting date, subject
to the terms of the award agreement). |
Reporting
Owners
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Reporting Owner Name / Address |
Relationships
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Director |
10% Owner |
Officer |
Other |
Trojanowski Amy
C/O ARMSTRONG FLOORING, INC.
2500 COLUMBIA AVE. PO BOX 3025
LANCASTER, PA 17603 |
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|
SVP, CFO |
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Signatures
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/s/ Christopher S. Parisi,
Attorney-in-fact |
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10/19/2020 |
**Signature of Reporting
Person |
Date |