Statement of Changes in Beneficial Ownership (4)
March 16 2021 - 5:38PM
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
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Livshitz Victoria |
2. Issuer Name and Ticker or Trading Symbol
GRID DYNAMICS HOLDINGS, INC.
[
GDYN
]
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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 of Customer Success |
(Last)
(First)
(Middle)
C/O GRID DYNAMICS HOLDINGS, INC., 5000 EXECUTIVE PARKWAY, SUITE 520 |
3. Date of Earliest Transaction
(MM/DD/YYYY)
3/13/2021 |
(Street)
SAN RAMON, CA 94583
(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 | 3/13/2021 | | F | | 16299 (1) | D | $15.48 | 223888 | D | |
Common Stock | | | | | | | | 627414 | I | See footnote (2) |
Common Stock | | | | | | | | 269176 | I | See footnote (3) |
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) | Represents shares that have been withheld by the Issuer to satisfy tax withholding and remittance obligations in connection with the net settlement of restricted stock units. |
(2) | The shares are held of record by the Victoria Livschitz Charitable Trust, for which the Reporting Person serves as trustee. Includes 349,610 shares received as a liquidating distribution from VLSK 2019 LLC in a transaction that was pro rata, in-kind, without consideration, in accordance with the exemptions under Rule 16a-9(a) and Rule 16a-13 of the Securities Exchange Act of 1934, as amended. In prior reports the Reporting Person reported beneficial ownership of the shares of Issuer held by VLSK 2019 LLC. |
(3) | The shares are held of record by the Livschitz Children's Charitable Trust, for which the Reporting Person serves as trustee. Victoria Livschitz Charitable Trust, for which the Reporting Person serves as trustee. Includes 149,833 shares received as a liquidating distribution from VLSK 2019 LLC in a transaction that was pro rata, in-kind, without consideration, in accordance with the exemptions under Rule 16a-9(a) and Rule 16a-13 of the Securities Exchange Act of 1934, as amended. In prior reports the Reporting Person reported beneficial ownership of the shares of Issuer held by VLSK 2019 LLC. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Livshitz Victoria C/O GRID DYNAMICS HOLDINGS, INC. 5000 EXECUTIVE PARKWAY, SUITE 520 SAN RAMON, CA 94583 |
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| EVP of Customer Success |
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Signatures
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/s/ Anil Doradla, by power of attorney | | 3/16/2021 |
**Signature of Reporting Person | Date |
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