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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 | ||||||||
Employee Stock Option (right to buy) | $ 4.38 (1) | 12/06/2013 | A | 11,025 (1) | 03/06/2014 | 12/06/2023 | Class A Common Stock | 11,025 (1) | $ 4.38 (1) | 11,025 (1) | D | ||||
Employee Stock Option (right to buy) | $ 4.08 (2) | 07/02/2014 | A | 10,500 (2) | 10/02/2014 | 07/02/2024 | Class A Common Stock | 10,500 (2) | $ 4.08 (2) | 10,500 (2) | D | ||||
Employee Stock Option (right to buy) | $ 4.77 (3) | 12/05/2014 | A | 21,000 (3) | 03/05/2015 | 12/05/2024 | Class A Common Stock | 21,000 (3) | $ 4.77 (3) | 21,000 (3) | D | ||||
Employee Stock Option (right to buy) | $ 6.72 (4) | 12/04/2015 | A | 20,000 (4) | 03/04/2016(4) | 12/04/2025 | Class A Common Stock | 20,000 (4) | $ 6.72 (4) | 20,000 (4) | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Overbaugh Jason G. 13471 SOUTH TUSCALEE WAY DRAPER, UT 84020 |
X | VP/Natnl Marketing Dir LifeIns |
/s/ Jason G. Overbaugh | 12/30/2015 | |
**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) | This option was granted on December 6, 2013 as an option to purchase 10,000 shares of Class A Common Stock at an exercise price of $4.85 per share, but adjusted pursuant to the anti-dilution provisions of the 2003 Stock Option Plan to reflect 5% stock dividends paid on February 7, 2014 and February 6, 2015. |
(2) | This option was granted on July 2, 2014 as an option to purchase 10,000 shares of Class A Common Stock at an exercise price of $4.29 per share, but adjusted pursuant to the anti-dilution provisions of the 2013 Stock Option Plan to reflect a 5% stock dividend paid on February 6, 2015. |
(3) | This option was granted on December 5, 2014 as an option to purchase 20,000 shares of Class A Common Stock at an exercise price of $5.02 per share, but adjusted pursuant to the anti-dilution provisions of the 2013 Stock Option Plan to reflect a 5% stock dividend paid on February 6, 2015. |
(4) | This option was granted on December 4, 2015 as an option to purchase 20,000 shares of Class A Common Stock at an exercise price of $6.72 per share. This option vests in four equal quarterly installments of Class A Common Stock, beginning on March 4, 2016, until such shares are fully vested. |