Statement of Changes in Beneficial Ownership (4)
October 20 2021 - 04:30PM
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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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 * Trojanowski Amy |
2. Issuer Name and Ticker or Trading
Symbol Armstrong Flooring, Inc. [ AFI ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)_____
Director _____
10% Owner
__X__ Officer (give title
below) _____ Other
(specify below)
SVP, CFO |
(Last)
(First)
(Middle)
C/O ARMSTRONG FLOORING, INC., 1770 HEMPSTEAD ROAD |
3. Date of Earliest Transaction (MM/DD/YYYY)
10/19/2021
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(Street)
LANCASTER, PA 17605
(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 |
Table I - Non-Derivative Securities Acquired, Disposed of, or
Beneficially Owned
|
1.Title of Security
(Instr. 3) |
2. Trans. Date |
2A. Deemed Execution Date, if any |
3. Trans. Code
(Instr. 8) |
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5) |
5. Amount of Securities Beneficially Owned Following
Reported Transaction(s)
(Instr. 3 and 4) |
6. Ownership Form: Direct (D) or Indirect (I)
(Instr. 4) |
7. Nature of Indirect Beneficial Ownership (Instr.
4) |
Code |
V |
Amount |
(A) or (D) |
Price |
Common Stock |
10/19/2021 |
|
M |
|
20000 (1) |
A |
$3.06 |
50000 |
D |
|
Common Stock |
10/19/2021 |
|
F |
|
5596 (2) |
D |
$3.06 |
44404 |
D |
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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 |
(3) |
10/19/2021 |
|
M |
|
|
20000 |
10/19/2021 |
(4) |
Common Stock |
20000 |
$0.00 |
80000 |
D |
|
Explanation of
Responses: |
(1) |
Reflects the conversion of
previously granted restricted stock units into shares of Issuer's
common stock in connection with the vesting of the restricted stock
units. Each restricted stock unit represents a contingent right to
receive one share of Issuer's common stock. |
(2) |
Represents the number of
shares withheld by the Issuer to satisfy the Reporting Person's tax
obligations upon the vesting of restricted stock awards granted to
the Reporting Person. |
(3) |
Each restricted stock unit
represents a contingent right to receive one share of the Issuer's
common stock. |
(4) |
Not applicable. |
Reporting
Owners
|
Reporting Owner Name / Address |
Relationships
|
Director |
10% Owner |
Officer |
Other |
Trojanowski Amy
C/O ARMSTRONG FLOORING, INC.
1770 HEMPSTEAD ROAD
LANCASTER, PA 17605 |
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|
SVP, CFO |
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Signatures
|
/s/Christopher S. Parisi, as
Attorney-in-fact |
|
10/20/2021 |
**Signature of Reporting
Person |
Date |
Armstrong Flooring (NYSE:AFI)
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