Statement of Changes in Beneficial Ownership (4)
July 18 2022 - 8:11AM
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).
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
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3235-0287
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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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Hough Laurie M. |
2. Issuer Name and Ticker or Trading Symbol
Skyline Champion Corp
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SKY
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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, CFO, Treasurer |
(Last)
(First)
(Middle)
C/O SKYLINE CHAMPION CORPORATION, 755 W. BIG BEAVER RD., SUITE 1000 |
3. Date of Earliest Transaction
(MM/DD/YYYY)
7/13/2022 |
(Street)
TROY, MI 48084
(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 | 7/13/2022 | | A | | 1759 (1) | A | $50.00 | 75995 | D | |
Common Stock | 7/13/2022 | | F | | 2302 (2) | D | $50.00 | 73693 | 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 |
Explanation of Responses: |
(1) | The amount of securities owned reflects the incremental vesting of a portion of PRSUs previously granted to the Reporting Person under the 2018 Equity Incentive Plan of Issuer and reported as owned directly at the target (100%) level. Pursuant to the terms of the award agreement evidencing the grant of the PRSUs, upon the Compensation Committee certification of the achievement of the performance goals on July 13, 2022, the PRSUs vested at 150% of the initial target award based upon the total shareholder return from July 1, 2019 through July 1, 2022 relative to the total shareholder return of certain designated companies over that same time period. |
(2) | Shares withheld by the Issuer to satisfy the tax withholding obligations of the Reporting Person in connection with the vesting and delivery of performance-based restricted stock units (PRSUs) following the Compensation Committee certification of the achievement of performance goals on July 13, 2022. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Hough Laurie M. C/O SKYLINE CHAMPION CORPORATION 755 W. BIG BEAVER RD., SUITE 1000 TROY, MI 48084 |
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| EVP, CFO, Treasurer |
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Signatures
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/s/ Caren A. Ries, Attorney-in-Fact | | 7/18/2022 |
**Signature of Reporting Person | Date |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. |
* | If the form is filed by more than one reporting person, see Instruction 4(b)(v). |
** | Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
Note: | File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. |
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. |
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