0001209191-17-014745.txt : 20170227 0001209191-17-014745.hdr.sgml : 20170227 20170227162056 ACCESSION NUMBER: 0001209191-17-014745 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170223 FILED AS OF DATE: 20170227 DATE AS OF CHANGE: 20170227 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: BLACKHAWK NETWORK HOLDINGS, INC CENTRAL INDEX KEY: 0001411488 STANDARD INDUSTRIAL CLASSIFICATION: FINANCE SERVICES [6199] IRS NUMBER: 432099257 STATE OF INCORPORATION: DE FISCAL YEAR END: 0103 BUSINESS ADDRESS: STREET 1: 6220 STONERIDGE MALL ROAD CITY: PLEASANTON STATE: CA ZIP: 94588 BUSINESS PHONE: 925-226-9990 MAIL ADDRESS: STREET 1: 6220 STONERIDGE MALL ROAD CITY: PLEASANTON STATE: CA ZIP: 94588 FORMER COMPANY: FORMER CONFORMED NAME: BLACKHAWK NETWORK HOLDINGS INC DATE OF NAME CHANGE: 20070904 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Ulrich Jerry N CENTRAL INDEX KEY: 0001572913 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35882 FILM NUMBER: 17641943 MAIL ADDRESS: STREET 1: C/O BLACKHAWK NETWORK HOLDINGS, INC. STREET 2: 6220 STONERIDGE MALL ROAD CITY: PLEASANTON STATE: CA ZIP: 94588 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2017-02-23 0 0001411488 BLACKHAWK NETWORK HOLDINGS, INC HAWK 0001572913 Ulrich Jerry N 6220 STONERIDGE MALL ROAD PLEASANTON CA 94588 0 1 0 0 CFO & Chief Admin Officer Common Stock 2017-02-23 4 M 0 2463 A 61320 D Common Stock 2017-02-23 4 M 0 17500 13.631 A 78820 D Common Stock 2017-02-23 4 S 0 17500 37.5971 D 61320 D Common Stock 6000 I See Footnote Restricted Stock Unit (RSU) 2017-02-23 4 M 0 2463 0.00 D Common Stock 2463 4924 D Stock Option (Right to Buy) 13.631 2017-02-23 4 M 0 17500 0.00 D Common Stock 17500 0 D Each restricted stock unit represents a contingent right to receive one share of the Company's Common Stock. Transaction executed in multiple trades at prices ranging from $37.50 to $37.775 per share, inclusive. The price reported in column 4 of Table I above reflects the weighted average sale price per share. The Reporting Person hereby undertakes to provide the SEC staff, the Issuer or a security holder of the Issuer, upon request, full information regarding the number of shares sold at each respective price within the range set forth in this footnote. The shares are held by The Ulrich Family Trust Dated November 1, 1996 as Amended and Restated in 2011. The restricted stock units vest pursuant to the following schedule: Twenty-Five Percent (25%) of the shares subject to the option vest on each of the first, second, third, and fourth anniversary of February 23, 2015, subject to the Reporting Person's continued employment or service relationship with the Issuer on each such vesting date. The shares subject to this option are fully vested and exercisable. The shares vest pursuant to the following schedule: Twenty Percent (20%) of the shares subject to the option vest on each of the first, second, third, fourth and fifth anniversary of March 9, 2010, subject to the Reporting Person's continued employment or service relationship with the Issuer on each such vesting date. /s/Yang Liu, Attorney-In-Fact 2017-02-27