Statement of Changes in Beneficial Ownership (4)
June 16 2020 - 4:34PM
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
*
Salzberg Matthew B |
2. Issuer Name and Ticker or Trading Symbol
Blue Apron Holdings, Inc.
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APRN
]
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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 BLUE APRON HOLDINGS, INC., 28 LIBERTY STREET |
3. Date of Earliest Transaction
(MM/DD/YYYY)
6/13/2020 |
(Street)
NEW YORK, NY 10005
(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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Class A Common Stock | 6/13/2020 | | M | | 12848 (1) | A | (2) | 24464 (1) | 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 |
Restricted Stock Units | (2) | 6/13/2020 | | M | | | $12848 (1) | (3) | (3) | Class A Common Stock | 12848 (1) | $0 | 0 | D | |
Restricted Stock Units | (4) | 6/15/2020 | | A | | 8334 | | (5) | (5) | Class A Common Stock | 8334 (1) | $0 | 8334 (1) | D | |
Explanation of Responses: |
(1) | On June 14, 2019, the issuer effected a 1-for-15 reverse stock split of its Class A Common Stock and Class B Common Stock (the "Reverse Stock Split"). The amount of securities reported on this Form 4 are on a post-Reverse Stock Split basis and are adjusted to reflect the Reverse Stock Split. |
(2) | Restricted stock units ("RSUs") convert into Class A Common Stock on a one-for-one basis. This transaction represents the settlement of RSUs in shares of Class A Common Stock on their scheduled vesting date. |
(3) | On June 13, 2019, the reporting person was granted 12,848 RSUs, vesting in full on the earlier of June 13, 2020 and the date of the issuer's 2020 annual meeting of stockholders. |
(4) | Each RSU represents a contingent right to receive one share of Class A Common Stock. |
(5) | The RSUs are scheduled to vest in full on the earlier of June 15, 2021 and the date of the issuer's 2021 annual meeting of stockholders. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Salzberg Matthew B C/O BLUE APRON HOLDINGS, INC. 28 LIBERTY STREET NEW YORK, NY 10005 | X |
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Signatures
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/s/ Meredith Deutsch, as attorney-in-fact for Matthew B. Salzberg | | 6/16/2020 |
**Signature of Reporting Person | Date |
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