0000899243-17-017789.txt : 20170705 0000899243-17-017789.hdr.sgml : 20170705 20170705162741 ACCESSION NUMBER: 0000899243-17-017789 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170630 FILED AS OF DATE: 20170705 DATE AS OF CHANGE: 20170705 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Broadstone Net Lease Inc CENTRAL INDEX KEY: 0001424182 STANDARD INDUSTRIAL CLASSIFICATION: REAL ESTATE INVESTMENT TRUSTS [6798] IRS NUMBER: 000000000 STATE OF INCORPORATION: MD FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 800 CLINTON SQUARE CITY: Rochester STATE: NY ZIP: 14604 BUSINESS PHONE: 585-287-6500 MAIL ADDRESS: STREET 1: 800 CLINTON SQUARE CITY: Rochester STATE: NY ZIP: 14604 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: TAIT AMY L CENTRAL INDEX KEY: 0001142301 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-55774 FILM NUMBER: 17948483 MAIL ADDRESS: STREET 1: C/O HOME PROPERTIES STREET 2: 850 CLINTON SQUARE CITY: ROCHESTER STATE: NY ZIP: 14604 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2017-06-30 0 0001424182 Broadstone Net Lease Inc NA 0001142301 TAIT AMY L 800 CLINTON SQUARE ROCHESTER NY 14604 1 1 0 0 See Remarks Common Stock 2017-06-30 5 G 0 E 12500 0.00 D 31925 I By Limited Liability Company Common Stock 4908 I By Spouse Common Stock 180918.61 I By Family Limited Liability Company Common Stock 10160 D Securities held by a limited liability company with respect to which the reporting person and her spouse have shared voting and investment power. The reporting person disclaims beneficial ownership of these securities, and this report shall not be deemed an admission that the reporting person is the beneficial owner of such securities for any purpose. Securities held by a family limited liability company with respect to which the reporting person has shared voting and investment power. The reporting person disclaims beneficial ownership of these securities, and this report shall not be deemed an admission that the reporting person is the beneficial owner of such securities for any purpose. Chief Investment Officer and Executive Chairman of the Board /s/ John D. Moragne, as Attorney-in-Fact 2017-07-05