Initial Statement of Beneficial Ownership (3)
March 15 2019 - 12:39PM
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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Simmons Darren
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2. Date of Event Requiring Statement (MM/DD/YYYY)
3/7/2019
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3. Issuer Name
and
Ticker or Trading Symbol
Everi Holdings Inc. [EVRI]
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(Last)
(First)
(Middle)
7250 S. TENAYA WAY SUITE 100
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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)
EVP /
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(Street)
LAS VEGAS, NV 89113
(City)
(State)
(Zip)
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5. 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 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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3429
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D
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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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Stock Option
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(1)
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2/16/2020
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Common Stock
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1050.0
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$7.77
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D
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Stock Option
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(2)
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3/1/2021
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Common Stock
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11250.0
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$3.41
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D
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Stock Option
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(3)
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3/2/2022
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Common Stock
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14584.0
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$5.58
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D
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Stock Option
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(4)
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3/6/2023
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Common Stock
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12453.0
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$7.09
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D
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Stock Option
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(5)
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5/2/2024
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Common Stock
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45000.0
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$6.59
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D
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Stock Option
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(6)
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4/22/2025
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Common Stock
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75000.0
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$7.74
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D
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Stock Option
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(7)
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5/13/2026
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Common Stock
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50000.0
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$1.46
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D
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Stock Option
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(8)
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3/8/2027
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Common Stock
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50000.0
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$3.29
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D
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Restricted Stock Units
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(9)
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(9)
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Common Stock
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16000.0
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(10)
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D
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Explanation of Responses:
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(1)
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Represents an option to purchase 1,050 shares of the Company's common stock, which have vested in 1/4 of shares at anniversary of the grant, and thereafter 1/36th of the remaining shares subject to the option grant vested on each monthly anniversary date of the option grant of February 16, 2010.
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(2)
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Represents an option to purchase 11,250 shares of the Company's common stock, which have vested in 1/4 of shares at anniversary of the grant, and thereafter 1/36th of the remaining shares subject to the option grant vested on each monthly anniversary date of the option grant of March 1, 2011.
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(3)
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Represents an option to purchase 14,584 shares of the Company's common stock, which have vested in 1/4 of shares at anniversary of the grant, and thereafter 1/36th of the remaining shares subject to the option grant vested on each monthly anniversary date of the option grant of March 2, 2012.
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(4)
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Represents an option to purchase 12,453 shares of the Company's common stock, which have vested in 1/4 of shares at anniversary of the grant, and thereafter 1/36th of the remaining shares subject to the option grant vested on each monthly anniversary date of the option grant of March 6, 2013.
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(5)
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Represents an option to purchase 45,000 shares of the Company's common stock, which have vested in equal installments on each of the first four anniversary dates of the grant of May 2, 2014.
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(6)
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Represents an option to purchase 75,000 shares of the Company's common stock, which will vest in equal installments on each of the first four anniversary dates of the grant of April 22, 2015.
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(7)
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Represents an option to purchase 50,000 shares of the Company's common stock, which will vest in equal installments on each of the first four anniversary dates of the grant of May 13, 2016.
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(8)
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Represents an option to purchase 50,000 shares of the Company's common stock, which will vest in equal installments on each of the first four anniversary dates of the grant of March 8, 2017.
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(9)
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Represents restricted stock units to acquire shares of the Company's common stock that will vest in equal installments on each of the first four anniversary dates of the grant of May 22, 2018.
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(10)
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Each restricted stock unit represents a contingent right to receive one share of common stock.
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Remarks:
Exhibit 24 - Limited Power of Attorney
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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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Simmons Darren
7250 S. TENAYA WAY SUITE 100
LAS VEGAS, NV 89113
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EVP
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Signatures
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/s/ Darren Simmons by Todd A. Valli, Attorney-in-Fact
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3/15/2019
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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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