0001209191-18-001051.txt : 20180103 0001209191-18-001051.hdr.sgml : 20180103 20180103170634 ACCESSION NUMBER: 0001209191-18-001051 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20171229 FILED AS OF DATE: 20180103 DATE AS OF CHANGE: 20180103 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: MARTINEZ MARIA D. CENTRAL INDEX KEY: 0001633672 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34061 FILM NUMBER: 18506503 MAIL ADDRESS: STREET 1: C/O HSN, INC. STREET 2: 1 HSN DRIVE CITY: SAINT PETERSBURG STATE: FL ZIP: 33729 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: HSN, Inc. CENTRAL INDEX KEY: 0001434729 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-MISCELLANEOUS SHOPPING GOODS STORES [5940] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1 HSN DRIVE CITY: ST. PETERSBURG STATE: FL ZIP: 33729 BUSINESS PHONE: 727-872-1000 MAIL ADDRESS: STREET 1: 1 HSN DRIVE CITY: ST. PETERSBURG STATE: FL ZIP: 33729 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2017-12-29 1 0001434729 HSN, Inc. HSNI 0001633672 MARTINEZ MARIA D. C/O HSN, INC. 1 HSN DRIVE SAINT PETERSBURG FL 33729 0 1 0 0 Chief Human Resources Officer Common Stock, par value $0.01 per share 2017-12-29 4 D 0 5014.702 D 0 D Restricted Stock Units 2017-12-29 4 D 0 5386.788 D Common Stock, par value $0.01 per share 5386.788 0 D Share Appreciation Right 51.58 2017-12-29 4 D 0 2831 D 2014-02-12 2023-02-12 Common Stock, par value $0.01 per share 2831 0 D Share Appreciation Right 47.72 2017-12-29 4 D 0 4610 D 2015-02-12 2024-02-12 Common Stock, par value $0.01 per share 4610 0 D Share Appreciation Right 65.24 2017-12-29 4 D 0 11429 D 2016-02-10 2025-02-10 Common Stock, par value $0.01 per share 11429 0 D Share Appreciation Right 44.86 2017-12-29 4 D 0 21981 D 2017-02-16 2026-02-16 Common Stock, par value $0.01 per share 21981 0 D Share Appreciation Right 38.80 2017-12-29 4 D 0 24236 D 2018-02-23 2027-02-23 Common Stock, par value $0.01 per share 24236 0 D Per the terms of the Agreement and Plan of Merger, dated as of July 5, 2017, by and among HSN, Inc., a Delaware corporation ("HSNI"), Liberty Interactive Corporation, a Delaware corporation, and Liberty Horizon, Inc., a Delaware corporation and a direct, wholly-owned subsidiary of Liberty Interactive (the "Merger Agreement"), each share of HSNI common stock was converted to 1.65 shares of Liberty Interactive Series A QVC Group common stock ("Liberty QVCA common stock") rounded down to the nearest number of whole shares with any fractional shares being paid out in cash based on the market closing price of Liberty QVCA common stock on December 29, 2017. Each Restricted Stock Unit ("RSU") is the economic equivalent of one share of HSNI common stock. Per the terms of the Merger Agreement, each RSU was converted into an RSU equivalent to 1.65 shares of Liberty QVCA common stock and rounded to the nearest whole share. Per the terms of the award agreement, upon the occurrence of the later of (i) the effective time of the Merger Agreement and (ii) the individual's separation from service, each unvested RSU becomes fully vested. Per the terms of the Merger Agreement, the Share Appreciation Right ("SAR") was converted into a SAR for shares of Liberty QVCA common stock by multiplying the number of shares in Table II, Column 7 by 1.65 (rounded down to the nearest number of whole shares) at an exercise price per share equal to the exercise price in Table II, Column 2 divided by 1.65 and rounded up to the nearest whole cent. Per the terms of the award agreement: (i) to the extent unvested, the award will vest upon the occurrence of the later of (a) the effective time of the Merger Agreement and (b) the individual's separation from service, and (ii) after a change of control and separation from service, the SAR expires on the earlier of (c) the original expiration date of the SAR or (d) one year following the individual's separation from service. /s/ Harold Herman, as attorney-in-fact 2018-01-03