0000914190-15-000482.txt : 20151117 0000914190-15-000482.hdr.sgml : 20151117 20151117161201 ACCESSION NUMBER: 0000914190-15-000482 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20151110 FILED AS OF DATE: 20151117 DATE AS OF CHANGE: 20151117 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: TILE SHOP HOLDINGS, INC. CENTRAL INDEX KEY: 0001552800 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-HOME FURNITURE, FURNISHINGS & EQUIPMENT STORES [5700] IRS NUMBER: 455538095 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 14000 CARLSON PARKWAY CITY: PLYMOUTH STATE: MN ZIP: 55441 BUSINESS PHONE: 763-852-2978 MAIL ADDRESS: STREET 1: 14000 CARLSON PARKWAY CITY: PLYMOUTH STATE: MN ZIP: 55441 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Watts William E CENTRAL INDEX KEY: 0001505895 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35629 FILM NUMBER: 151238328 MAIL ADDRESS: STREET 1: 111 HUNTINGTON AVENUE STREET 2: SUITE 2900 CITY: BOSTON STATE: MA ZIP: 02199 4 1 edgar.xml PRIMARY DOCUMENT X0306 4 2015-11-10 0001552800 TILE SHOP HOLDINGS, INC. TTS 0001505895 Watts William E C/O TILE SHOP HOLDINGS, INC. 14000 CARLSON PARKWAY PLYMOUTH MN 55441 1 0 0 0 Common Stock 2015-11-10 5 G 0 5000 0 D 232108 D As previously reported, includes 18,012 shares of restricted stock granted pursuant to the Company's 2012 Omnibus Award Plan, which are subject to a purchase option in favor of the Company until August 21, 2016. /s/ John R. Houston as Attorney-in-Fact for William E. Watts pursuant to Power of Attorney previously filed. 2015-11-17