-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, UrYsuffq1i1vUfjU6qtguNRmT1NQo0ckSQZuEox55OPW69CzLwS9gh8fFj/a3+EJ 4mCSTyI4bwLUWigxSacG3A== 0001181431-09-033301.txt : 20090701 0001181431-09-033301.hdr.sgml : 20090701 20090701173930 ACCESSION NUMBER: 0001181431-09-033301 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20090630 FILED AS OF DATE: 20090701 DATE AS OF CHANGE: 20090701 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: JACKSON HEWITT TAX SERVICE INC CENTRAL INDEX KEY: 0001283552 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PERSONAL SERVICES [7200] IRS NUMBER: 200778892 STATE OF INCORPORATION: DE FISCAL YEAR END: 0430 BUSINESS ADDRESS: STREET 1: 3 SYLVAN WAY CITY: PARSIPPANY STATE: NJ ZIP: 07054 BUSINESS PHONE: 9736301040 MAIL ADDRESS: STREET 1: 3 SYLVAN WAY CITY: PARSIPPANY STATE: NJ ZIP: 07054 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: BARNETT STEVEN L CENTRAL INDEX KEY: 0001230624 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-32215 FILM NUMBER: 09923678 MAIL ADDRESS: STREET 1: 3 SYLVAN WAY CITY: PARSIPPANY STATE: NJ ZIP: 07054 4 1 rrd245479.xml X0303 4 2009-06-30 0 0001283552 JACKSON HEWITT TAX SERVICE INC JTX 0001230624 BARNETT STEVEN L 3 SYLVAN WAY PARSIPPANY NJ 07054 0 1 0 0 EVP, General Counsel Common Stock 2009-06-30 4 D 0 15595 0 D 13179 D Stock Option 14.5 2009-06-30 4 D 0 20372 0 D 2018-07-17 Common Stock 20372 221786 D Represents shares of restricted stock forfeited due to the Company's failure to achieve the performance criteria required for vesting of this award. 6,585 of these shares are restricted stock and subject to time vesting granted under the Jackson Hewitt Tax Service Inc. Amended and Restated 2004 Equity and Incentive Plan. Represents stock options forfeited due to the Company's failure to achieve the performance criteria required for vesting of this award. Option was granted on July 17, 2008 under the Jackson Hewitt Tax Service Inc. Amended and Restated 2004 Equity and Incentive Plan. Option was to become exercisable with respect to one third of the shares on each of the first three anniversaries of the date of grant subject to a three year vesting period that commenced on the date of grant; provided that the required performance vesting criteria had been met. /s/ Steven L. Barnett 2009-07-02 -----END PRIVACY-ENHANCED MESSAGE-----