Statement of Changes in Beneficial Ownership (4)
February 11 2022 - 5:38PM
Edgar (US Regulatory)
FORM 4
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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
*
Raphaelson Ira H |
2. Issuer Name and Ticker or Trading Symbol
Inspired Entertainment, Inc.
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INSE
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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)
C/O INSPIRED ENTERTAINMENT, INC., 250 WEST 57TH STREET, SUITE 415 |
3. Date of Earliest Transaction
(MM/DD/YYYY)
2/9/2022 |
(Street)
NEW YORK, NY 10107
(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 | 2/9/2022 | | A(1) | | 299 | A | (1) | 9170 (3) | D | |
Common Stock | 2/9/2022 | | D(2) | | 572 | D | (2) | 8598 (3) | D | |
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) | Reflects an incremental grant of restricted stock units under the Issuer's non-employee director compensation policy in connection with the reporting person's role as committee chair. A pro rata portion of the units vested upon grant (48 units) and the remainder will vest in three equal installments on each of April 1, 2022, July 1, 2022 and October 1, 2022. The units convert into shares of common stock on a one-for-one basis. |
(2) | Reflects cancellation of a portion of the restricted stock units granted to the reporting person on January 3, 2022 in connection with his ceasing to serve as the Issuer's lead director. |
(3) | Does not include 42,716 restricted stock units from awards received in prior years which were reported by the reporting person on Table II of the Form 4 for the applicable awards and which are subject to deferred settlement until the reporting person ceases to serve as a member of the Issuer's board of directors or upon a change in control of the Issuer. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Raphaelson Ira H C/O INSPIRED ENTERTAINMENT, INC. 250 WEST 57TH STREET, SUITE 415 NEW YORK, NY 10107 | X |
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Signatures
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/s/ Carys Damon, Attorney-in-Fact | | 2/11/2022 |
**Signature of Reporting Person | Date |
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