Amended Statement of Changes in Beneficial Ownership (4/a)
May 17 2021 - 4:38PM
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
*
Bourne Jon |
2. Issuer Name and Ticker or Trading Symbol
GTY Technology Holdings Inc.
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GTYH
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director _____ 10% Owner __X__ Officer (give title below) _____ Other (specify below) EVP AND GENERAL COUNSEL |
(Last)
(First)
(Middle)
SUITE 100 |
3. Date of Earliest Transaction
(MM/DD/YYYY)
4/30/2021 |
(Street)
LAS VEGAS, NV 89144
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
5/4/2021 |
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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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 Units | (1) | 4/30/2021 | | J (2) | | | 15000 | (1) | (1) | Common Stock | 15000 | $0 | 20782 | D | |
Explanation of Responses: |
(1) | Each restricted stock unit would have represented a contingent right to receive one share of the issuer's common stock. If the reporting person were to have remained employed with the issuer at such time, the restricted stock units would have vested in three substantially equal installments on February 19, 2022, February 19, 2023 and February 19, 2024. The restricted stock units could have been settled in shares of the issuer's common stock or cash. |
(2) | On May 4, 2021, the reporting person filed a Form 4 based on the understanding that an additional 15,000 restricted stock units had been granted. Subsequent communications made clear, however, that a misunderstanding had occurred and those additional restricted stock units had not in fact been granted. This amended Form 4, accordingly, is being filed to correct the prior Form 4 and reflect the absence of any such additional grant. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Bourne Jon SUITE 100 LAS VEGAS, NV 89144 |
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| EVP AND GENERAL COUNSEL |
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Signatures
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/s/ Jon Bourne | | 5/17/2021 |
**Signature of Reporting Person | Date |
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