0001592379-19-000033.txt : 20190528 0001592379-19-000033.hdr.sgml : 20190528 20190528173721 ACCESSION NUMBER: 0001592379-19-000033 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190523 FILED AS OF DATE: 20190528 DATE AS OF CHANGE: 20190528 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Mounts L David CENTRAL INDEX KEY: 0001341690 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36432 FILM NUMBER: 19858849 MAIL ADDRESS: STREET 1: 3910 WHITE HAWK LN CITY: WINSTON-SALEM STATE: NC ZIP: 27106 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Papa Murphy's Holdings, Inc. CENTRAL INDEX KEY: 0001592379 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-EATING PLACES [5812] IRS NUMBER: 272349094 FISCAL YEAR END: 0102 BUSINESS ADDRESS: STREET 1: 8000 NE PARKWAY DRIVE STREET 2: SUITE 350 CITY: VANCOUVER STATE: WA ZIP: 98662 BUSINESS PHONE: 360 260-7272 MAIL ADDRESS: STREET 1: 8000 NE PARKWAY DRIVE STREET 2: SUITE 350 CITY: VANCOUVER STATE: WA ZIP: 98662 4 1 wf-form4_155907942547849.xml FORM 4 X0306 4 2019-05-23 1 0001592379 Papa Murphy's Holdings, Inc. FRSH 0001341690 Mounts L David C/O PAPA MURPHY'S HOLDINGS, INC. 8000 NE PARKWAY DRIVE, SUITE 350 VANCOUVER WA 98662 1 0 0 0 Common Stock, par value $0.01 per share 2019-05-23 4 U 0 13944 6.45 D 0 D Common Stock, par value $0.01 per share 2019-05-23 4 U 0 6000 6.45 D 0 I By children Common Stock, par value $0.01 per share 2019-05-23 4 U 0 213961 6.45 D 0 I By Trust Pursuant to the terms of the Agreement and Plan of Merger, dated April 10, 2019, by and among the Issuer, MTY Franchising USA, Inc. and MTY Columbia Merger Sub, Inc, on April 25, 2019, MTY Columbia Merger Sub, Inc. made an offer (the "Offer") to purchase each outstanding share of the Issuer's common stock for $6.45 per share, in cash, without interest and subject to applicable withholding. The shares shown on this line were tendered in the Offer. /s/ Daniel R. Smith attorney-in-fact 2019-05-28