Amended Statement of Ownership (sc 13g/a)
February 13 2023 - 4:32PM
Edgar (US Regulatory)
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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549 |
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SCHEDULE 13G
Under the Securities Exchange Act of 1934
(Amendment No. 12)* |
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Shoe Carnival, Inc. |
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(Name of Issuer)
Common Stock, $0.01 par value per share |
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(Title of Class of Securities)
824889109 |
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(CUSIP Number)
December 31, 2022 |
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(Date of Event Which Requires Filing of this Statement) |
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Check the appropriate box to designate the rule pursuant
to which this Schedule is filed:
¨
Rule 13d-1(b)
¨
Rule 13d-1(c)
x
Rule 13d-1(d)
*The remainder of this cover page shall
be filled out for a reporting person’s initial filing on this form with respect to the subject class of securities, and for any
subsequent amendment containing information which would alter the disclosures provided in a prior cover page.
The information required in the remainder of
this cover page shall not be deemed to be “filed” for the purpose of Section 18 of the Securities Exchange Act
of 1934 (“Act”) or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions
of the Act (however, see the Notes).
(continued on the following pages)
1 |
NAMES OF REPORTING PERSONS
J. Wayne Weaver |
2 |
CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (See Instructions)
(a) ¨
(b) x
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3 |
SEC USE ONLY
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4 |
CITIZENSHIP OR PLACE OF ORGANIZATION
United States |
NUMBER OF
SHARES
BENEFICIALLY OWNED BY
EACH REPORTING
PERSON WITH: |
5 |
SOLE VOTING POWER
3,681,529 (1) |
6 |
SHARED VOTING POWER
4,999,844 (2) |
7 |
SOLE DISPOSITIVE POWER
3,681,529 (1) |
8 |
SHARED DISPOSITIVE POWER
4,999,844 (2) |
9 |
AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
8,681,373 (1)(2) |
10 |
CHECK
IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES (See Instructions)
¨
N/A |
11 |
PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9)
32.0% (1)(2)(3) |
12 |
TYPE OF REPORTING PERSON (See Instructions)
IN |
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(1) | Represents the number of shares beneficially owned by Mr. Weaver
after his receipt of 267,917 shares from the J. Wayne Weaver 2020 Grantor Retained Annuity Trust for Leigh Anne Weaver (the “Leigh
Weaver 2020 GRAT”) as an annuity payment on May 23, 2022, in accordance with the terms of the Leigh Weaver 2020 GRAT. Leigh
Anne Weaver is the sole trustee of the Leigh Weaver 2020 GRAT and, as sole trustee, has sole voting and dispositive power with respect
to the shares held by the Leigh Weaver 2020 GRAT. Mr. Weaver does not have any voting or dispositive power over the shares held by the
Leigh Weaver 2020 GRAT. |
(2) | Includes 4,999,844 shares owned by Mr. Weaver’s spouse. |
(3) | Based
on 27,166,175 outstanding shares of the Issuer’s common stock as of November 23, 2022, as reported by the Issuer in its Quarterly
Report on Form 10-Q for the period ended October 29, 2022, filed with the Securities and Exchange Commission on December 2, 2022. |
1 |
NAMES OF REPORTING PERSONS
Delores B. Weaver |
2 |
CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (See Instructions)
(a) ¨
(b) x
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3 |
SEC USE ONLY
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4 |
CITIZENSHIP OR PLACE OF ORGANIZATION
United States |
NUMBER OF
SHARES
BENEFICIALLY OWNED BY
EACH REPORTING
PERSON WITH: |
5 |
SOLE VOTING POWER
4,999,844 |
6 |
SHARED VOTING POWER
3,681,529 (1) |
7 |
SOLE DISPOSITIVE POWER
4,999,844 |
8 |
SHARED DISPOSITIVE POWER
3,681,529 (1) |
9 |
AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
8,681,373 (1) |
10 |
CHECK
IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES (See Instructions)
¨
N/A |
11 |
PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9)
32.0% (1)(2) |
12 |
TYPE OF REPORTING PERSON (See Instructions)
IN |
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(1) | Includes 3,681,529 shares beneficially owned by Mrs. Weaver’s
spouse after Mr. Weaver’s receipt of 267,917 shares from the Leigh Weaver 2020 GRAT as an annuity payment on May 23, 2022, in accordance
with the terms of the Leigh Weaver 2020 GRAT. Leigh Anne Weaver is the sole trustee of the Leigh Weaver 2020 GRAT and, as sole trustee,
has sole voting and dispositive power with respect to the shares held by the Leigh Weaver 2020 GRAT. Mrs. Weaver’s spouse does
not have any voting or dispositive power over the shares held by the Leigh Weaver 2020 GRAT. |
(2) | Based on 27,166,175 outstanding shares of the Issuer’s
common stock as of November 23, 2022, as reported by the Issuer in its Quarterly Report on Form 10-Q for the period ended October 29,
2022, filed with the Securities and Exchange Commission on December 2, 2022. |
Item 1.
Shoe Carnival, Inc. (the “Issuer”)
| (b) | Address of Issuer’s Principal Executive Offices |
| | |
| | 7500 East Columbia Street |
| | Evansville, Indiana 47715 |
Item 2.
| (b) | Address of Principal Business Office or, if none, Residence |
| (i) | J. Wayne Weaver |
| | 7500 East Columbia Street |
| | Evansville, Indiana 47715 |
| (ii) | Delores B. Weaver |
| | 7500 East Columbia Street |
| | Evansville, Indiana 47715 |
| (i) | J. Wayne Weaver: |
United States |
| (ii) | Delores B. Weaver: |
United States |
| (d) | Title of Class of Securities |
Common Stock, par value $0.01 per
share (“Common Stock”)
824889109
Item 3. | If this statement is filed pursuant to §§ 240.13d-1(b) or 240.13d-2(b) or (c), check whether the person
filing is a: |
| (a) | ¨ |
Broker or dealer registered
under section 15 of the Act. |
| (b) | ¨ |
Bank as defined in section
3(a)(6) of the Act. |
| (c) | ¨ |
Insurance company as defined
in section 3(a)(19) of the Act. |
| (d) | ¨ |
Investment company registered
under section 8 of the Investment Company Act of 1940. |
| (e) | ¨ |
An investment adviser in accordance
with § 240.13d-1(b)(1)(ii)(E). |
| (f) | ¨ |
An employee benefit plan or endowment fund in accordance with § 240.13d-1(b)(1)(ii)(F). |
| (g) | ¨ |
A parent holding company or control person in accordance with § 240.13d-1(b)(1)(ii)(G). |
| (h) | ¨ |
A savings association as defined
in Section 3(b) of the Federal Deposit Insurance Act. |
| (i) | ¨ |
A church plan that is excluded
from the definition of an investment company under section 3(c)(14) of the Investment
Company Act of 1940. |
| (j) | ¨ |
A non-U.S. institution in
accordance with § 240.13d-1(b)(1)(ii)(J). |
| (k) | ¨ |
Group, in accordance with
§ 240.13d-1(b)(1)(ii)(K). |
| (a) | Amount Beneficially
Owned |
| (i) | J. Wayne
Weaver: |
8,681,373 shares (1) |
| (ii) | Delores
B. Weaver: |
8,681,373 shares (2) |
| (i) | J. Wayne Weaver: |
32.0% (1)(3) |
| (ii) | Delores B. Weaver: |
32.0% (2)(3) |
| (c) | Number of shares as
to which such person has: |
| (i) | Sole power to vote or to direct the vote |
| (i) | J. Wayne Weaver: |
3,681,529 |
| (ii) | Delores B. Weaver: |
4,999,844 |
| (ii) | Shared power to vote or to direct the vote |
| (i) | J. Wayne Weaver: |
4,999,844 (1) |
| (ii) | Delores B. Weaver: |
3,681,529 (2) |
| (iii) | Sole power to dispose or to direct the disposition
of |
| (i) | J. Wayne Weaver: |
3,681,529 |
| (ii) | Delores B. Weaver: |
4,999,844 |
| (iv) | Shared power to dispose or to direct the disposition
of |
| (i) | J. Wayne Weaver: |
4,999,844 (1) |
| (ii) | Delores B. Weaver: |
3,681,529 (2) |
| (1) | Includes 4,999,844 shares owned by Mr. Weaver’s spouse. |
| (2) | Includes 3,681,529 shares owned by Mrs. Weaver’s spouse. |
| (3) | The percentage of shares beneficially owned is based on 27,166,175 outstanding shares of the Issuer’s common stock as of November
23, 2022, as reported by the Issuer in its Quarterly Report on Form 10-Q for the period ended October 29, 2022, filed with the Securities
and Exchange Commission on December 2, 2022. |
| Item 5. | Ownership of Five Percent or Less of
a Class |
If this statement
is being filed to report the fact that as of the date hereof the reporting person has ceased to be the beneficial owner of more than
five percent of the class of securities, check the following ¨.
Not Applicable
Item 6. | Ownership of More than Five Percent
on Behalf of Another Person. |
Not Applicable
Item 7. | Identification and Classification of
the Subsidiary Which Acquired the Security Being Reported on By the Parent Holding Company
or Control Person |
Not Applicable
Item 8. | Identification and Classification of
Members of the Group |
Not Applicable
Item 9. | Notice of Dissolution of Group |
Not Applicable
Not Applicable
SIGNATURE
After reasonable inquiry and to the best of my
knowledge and belief, I certify that the information set forth in this statement is true, complete and correct.
Date: February 13, 2023
By: |
/s/
J. Wayne Weaver |
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J. Wayne Weaver |
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By: |
/s/ Delores
B. Weaver |
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Delores B. Weaver |
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