Statement of Changes in Beneficial Ownership (4)
January 28 2022 - 8:02AM
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
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GOTSCHALL JEFFREY P |
2. Issuer Name and Ticker or Trading Symbol
SIFCO INDUSTRIES INC
[
SIF
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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)
970 E. 64TH STREET |
3. Date of Earliest Transaction
(MM/DD/YYYY)
1/26/2022 |
(Street)
CLEVELAND, OH 44103
(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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SIFCO Industries, Inc. Common Stock (1) | 1/26/2022 | | A | | 6402 | A | $0.00 | 6402 | D | |
Voting Trust Certificates (2) | | | | | | | | 219323 | D | |
SIFCO Industries, Inc. Common Stock | | | | | | | | 48098 | D | |
Voting Trust Certificates (2) | | | | | | | | 400 | I | Owned by spouse |
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 |
Explanation of Responses: |
(1) | Awarded 6,402 shares of the SIFCO Industries, Inc. common stock, which are restricted as of the date of the grant. Restriction to lapse on the day immediately preceding the one year anniversary date of this award. |
(2) | Voting Trust Certificates are for common stock of SIFCO Industries, Inc. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
GOTSCHALL JEFFREY P 970 E. 64TH STREET CLEVELAND, OH 44103 | X |
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Signatures
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/s/ Elizabeth Button - by power of attorney | | 1/28/2022 |
**Signature of Reporting Person | Date |
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