Statement of Changes in Beneficial Ownership (4)
December 14 2017 - 6:04PM
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).
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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
hours per response...
0.5
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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
*
WILT TOBY S
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2. Issuer Name
and
Ticker or Trading Symbol
CapStar Financial Holdings, Inc.
[
CSTR
]
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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)
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(Last)
(First)
(Middle)
1201 DEMONBREUN STREET, SUITE 700
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3. Date of Earliest Transaction
(MM/DD/YYYY)
12/12/2017
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(Street)
NASHVILLE, TN 37203
(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
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12/12/2017
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X
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3750
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A
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$10.00
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3750
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I
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WF Partners
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Common Stock
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12/12/2017
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X
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700
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A
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$10.00
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700
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I
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Lucianne Forcum Wilt Family Limited Partnership
(2)
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Common Stock
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12/12/2017
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X
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1500
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A
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$10.00
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1500
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I
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Lucianne Forcum Wilt
(2)
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Common Stock
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255240
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D
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Common Stock
(1)
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831
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D
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Common Stock
(3)
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488
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D
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Common Stock
(4)
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1017
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D
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Common Stock
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67036
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I
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WF Partners
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Common Stock
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25000
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I
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Joanne Wilt Banks
(2)
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Common Stock
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4800
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I
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Pershing LLC Cust Mark Banks IRA
(2)
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Common Stock
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5200
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I
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Mark R. Banks
(2)
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Common Stock
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20023
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I
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Wilt Fleming TR UA JAN 21 00 Samuel M. Fleming Charitable Lead Annuity Trust
(2)
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Common Stock
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12500
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I
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Dallas Hagewood Wilt
(2)
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Common Stock
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14000
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I
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Lucianne Forcum Wilt Family Limited Partnership
(2)
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Common Stock
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5000
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I
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James F. & Elissa Watkins, as joint tenants
(2)
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Common Stock
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30000
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I
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Lucianne Forcum Wilt
(2)
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Common Stock
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20000
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I
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Samuel Fleming Wilt
(2)
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Common Stock
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15045
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I
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Toby Stack Wilt, Jr.
(2)
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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. 3)
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2. Conversion or Exercise Price of Derivative Security
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3. Trans. Date
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3A. Deemed Execution Date, if any
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4. Trans. Code
(Instr. 8)
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5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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6. Date Exercisable and Expiration Date
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7. Title and Amount of Securities Underlying Derivative Security
(Instr. 3 and 4)
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8. Price of Derivative Security
(Instr. 5)
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9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4)
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10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4)
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11. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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(A)
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(D)
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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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Warrants (right to buy)
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$10.00
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12/12/2017
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X
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3750
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7/14/2008
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7/14/2018
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Common Stock
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3750
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$0.00
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0
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I
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WF Partners
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Warrants (right to buy)
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$10.00
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12/12/2017
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X
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700
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7/14/2008
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7/14/2018
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Common Stock
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700
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$0.00
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0
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I
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Lucianne Forcum Wilt Family Limited Partnership
(2)
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Warrants (right to buy)
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$10.00
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12/12/2017
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X
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1500
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7/14/2008
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7/14/2018
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Common Stock
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1500
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$0.00
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0
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I
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Lucianne Forcum Wilt
(2)
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Warrants (right to buy)
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$10.00
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7/14/2008
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7/14/2018
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Common Stock
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22500
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22500
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D
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Option (right to buy)
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$10.00
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(5)
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11/13/2018
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Common Stock
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12000
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12000
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D
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Option (right to buy)
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$10.00
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(6)
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1/20/2020
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Common Stock
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6000
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6000
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D
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Warrants (right to buy)
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$10.00
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7/14/2008
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7/14/2018
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Common Stock
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1250
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1250
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I
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Joanne Wilt Banks
(2)
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Warrants (right to buy)
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$10.00
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7/14/2008
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7/14/2018
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Common Stock
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500
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500
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I
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Mark R. Banks
(2)
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Warrants (right to buy)
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$10.00
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7/14/2008
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7/14/2018
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Common Stock
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1250
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1250
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I
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Wilt Fleming TR UA JAN 21 00 Samuel M. Fleming Charitable Lead Annuity Trust
(2)
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Warrants (right to buy)
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$10.00
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7/14/2008
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7/14/2018
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Common Stock
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625
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625
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I
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Dallas Hagewood Wilt
(2)
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Warrants (right to buy)
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$10.00
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7/14/2008
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7/14/2018
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Common Stock
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250
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250
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I
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James F. & Elissa Watkins, as joint tenants
(2)
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Warrants (right to buy)
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$10.00
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7/14/2008
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7/14/2018
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Common Stock
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1000
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1000
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I
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Samuel Fleming Wilt
(2)
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Warrants (right to buy)
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$10.00
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7/14/2008
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7/14/2018
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Common Stock
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1250
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1250
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I
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Toby Stack Wilt, Jr.
(2)
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Explanation of Responses:
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(1)
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The reported item represents the unvested portion of an award of restricted common stock granted on February 28, 2017. The award vests in three equal installments beginning on the first anniversary of the February 28, 2017 grant date.
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(2)
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The reporting person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein, and the inclusion of these shares in this report shall not be deemed an admission of beneficial ownership of all of the reported shares for purposes of Section 16 or for any other purpose.
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(3)
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The reported item represents the unvested portion of an award of restricted stock granted on February 27, 2015. The remaining 488 shares of restricted stotck under this award vest on the third anniversary of the grant date, or February 27, 2018.
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(4)
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The reported item represents the unvested portion of an award of restricted common stock granted on March 3, 2016. The remaining 1,017 shares of restricted common stock under this award vest on the second and third anniversaries of the March 3, 2016 grant date, or March 3, 2018 and March 3, 2019, respectively.
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(5)
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These options vested in four equal annual installments beginning one year after the November 13, 2008, grant date.
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(6)
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These options vested in four equal annual installments beginning one year after the January 20, 2010, grant date.
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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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WILT TOBY S
1201 DEMONBREUN STREET, SUITE 700
NASHVILLE, TN 37203
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X
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Signatures
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/s/ Rob Anderson, as Attorney-in-Fact for Toby S. Wilt
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12/14/2017
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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 4(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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