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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
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. | SEC 1474 (9-02) |
1. Title of Derivative Security (Instr. 3) |
2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction 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 (Month/Day/Year) |
7. Title and Amount of Underlying Securities (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) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Subscription rights to purchase common stock | $ 3.27 | 10/08/2012 | M(1)(4) | 839 | 09/11/2012 | 10/08/2012 | Common Stock | 191 | $ 0 (1) | 0 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Powell William A. 5500 TRILLIUM BOULEVARD SUITE 501 HOFFMAN ESTATES, IL 60192 |
Senior Vice President and COO |
/s/ Charles J. Hansen, as Attorney-in-Fact for William A. Powell | 03/17/2014 | |
**Signature of Reporting Person | Date |
* | 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). |
(1) | The Reporting Person exercised subscription rights issued to him by Sears Holdings Corporation to purchase shares of common stock on October 8, 2012. |
(2) | Represents shares acquired pursuant to the exercise of the basic subscription rights as well as shares acquired pursuant to the oversubscription privilege related to such subscription rights. The Reporting Person requested to purchase additional shares in connection with the oversubscription privilege related to such subscription rights and received notification of the additional shares allocated to him pursuant to the oversubscription privilege on October 12, 2012. |
(3) | The Reporting Person is filing this amended Form 4 to reflect the acquisition of 1 share of common stock that was previously unreported due to an administrative error. The 1 share was purchased pursuant to the exercise of subscription rights acquired from Sears Holdings Corporation. |
(4) | The price per whole share of Sears Hometown and Outlet Stores, Inc. common stock was $15.00. Each subscription right entitled the Reporting Person to purchase from Sears Holdings Corporation 0.218091 of a share of Sears Hometown and Outlet Stores, Inc. common stock. |