Statement of Changes in Beneficial Ownership (4)
November 09 2021 - 04:52PM
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
|
OMB
APPROVAL
OMB Number: 3235-0287
Estimated average burden
hours per response... 0.5 |
|
Filed pursuant to Section 16(a) of the
Securities Exchange Act of 1934 or Section 30(h) of the Investment
Company Act of 1940
|
|
| 1. Name
and Address of Reporting Person * Afsari Nasym |
2. Issuer Name and Ticker or Trading
Symbol Montrose Environmental Group, Inc. [ MEG
] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)_____
Director _____
10% Owner
__X__ Officer (give title
below) _____ Other
(specify below)
General Counsel and Secretary |
|
(Last)
(First)
(Middle)
5120 NORTHSHORE DR |
3. Date of Earliest Transaction (MM/DD/YYYY)
11/5/2021
|
|
(Street)
NORTH LITTLE ROCK, AR 72118
(City)
(State)
(Zip)
|
4. If Amendment, Date Original Filed
(MM/DD/YYYY)
|
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 |
11/5/2021 |
|
M |
|
6101 |
A |
$6.03 |
22851 |
D |
|
|
Common Stock |
11/5/2021 |
|
S |
|
6101 |
D |
$75.216 (1) |
16750 |
D |
|
|
Common Stock |
11/8/2021 |
|
M |
|
18208 |
A |
$6.03 |
34958 |
D |
|
|
Common Stock |
11/8/2021 |
|
S |
|
18208 |
D |
$75.024 (2) |
16750 |
D |
|
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible
securities)
|
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 |
|
Stock Option (Right to Buy) |
$6.03 |
11/5/2021 |
|
M |
|
|
6101 |
(3) |
6/23/2026 |
Common Stock |
6101 |
$0.00 |
90524 (4) |
D |
|
|
Stock Option (Right to Buy) |
$6.03 |
11/8/2021 |
|
M |
|
|
18208 |
(3) |
6/23/2026 |
Common Stock |
18208 |
$0.00 |
72316 |
D |
|
| Explanation of
Responses: |
| (1) |
The price reported in Column
4 is a weighted average price. These shares of common stock of the
Issuer were sold in multiple transactions by the Reporting Person
at prices ranging from $75.00 to $75.64, inclusive. The Reporting
Person undertakes to provide upon request by the Commission staff,
the Issuer, or a security holder of the Issuer full information
regarding the number of shares of common stock sold at each
separate price within the range. |
| (2) |
The price reported in Column
4 is a weighted average price. These shares of common stock of the
Issuer were sold in multiple transactions by the Reporting Person
at prices ranging from $75.00 to $75.29, inclusive. The Reporting
Person undertakes to provide upon request by the Commission staff,
the Issuer, or a security holder of the Issuer full information
regarding the number of shares of common stock sold at each
separate price within the range. |
| (3) |
50% of the shares subject to
the option vested on June 9, 2017 and the remaining 50% vested on
June 9, 2019. |
| (4) |
Form 4 filed by the
Reporting Person on September 23, 2021 incorrectly reflected the
number of options remaining following the exercise reported
thereon. The correct number of options that should have been
reflected thereon was 96,625. |
Remarks:
The transactions reported in this Form 4 were effected pursuant to
a Rule 10b5-1 Trading Plan adopted by the Reporting Person. |
Reporting
Owners
|
|
Reporting Owner Name / Address |
Relationships
|
|
Director |
10% Owner |
Officer |
Other |
Afsari Nasym
5120 NORTHSHORE DR
NORTH LITTLE ROCK, AR 72118 |
|
|
General Counsel and Secretary |
|
Signatures
|
|
/s/ Nasym Afsari |
|
11/9/2021 |
| **Signature of Reporting
Person |
Date |
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