0001104659-20-117887.txt : 20201023
0001104659-20-117887.hdr.sgml : 20201023
20201023204718
ACCESSION NUMBER: 0001104659-20-117887
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20201023
FILED AS OF DATE: 20201023
DATE AS OF CHANGE: 20201023
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Davis Mark Burton
CENTRAL INDEX KEY: 0001787766
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35629
FILM NUMBER: 201258840
MAIL ADDRESS:
STREET 1: C/O 14000 CARLSON PARKWAY
CITY: PLYMOUTH
STATE: MN
ZIP: 55441
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: 763-852-2950
MAIL ADDRESS:
STREET 1: 14000 CARLSON PARKWAY
CITY: PLYMOUTH
STATE: MN
ZIP: 55441
4
1
tm2034216-1_4.xml
OWNERSHIP DOCUMENT
X0306
4
2020-10-23
0
0001552800
TILE SHOP HOLDINGS, INC.
TTSH
0001787766
Davis Mark Burton
C/O TILE SHOP HOLDINGS, INC.
14000 CARLSON PARKWAY
PLYMOUTH
MN
55441
0
1
0
0
VP Inv. Relations & CAO
Common Stock
2020-10-23
4
F
0
4281
3.89
D
82354
D
Common Stock
820
I
By Child #1
Common Stock
775
I
By Child #2
Common Stock
765
I
By Child #3
Stock Option (Right to Buy)
8.58
2021-10-21
Common Stock
20000
20000
D
Stock Option (Right to Buy)
14.19
2022-07-14
Common Stock
2737
2737
D
Stock Option (Right to Buy)
8.5
2027-11-02
Common Stock
5400
5400
D
The reporting person has elected to satisfy his tax withholding obligation in connection with the vesting of a prior restricted stock grant by directing the Issuer to withhold shares otherwise issuable upon vesting of the previously reported grant.
Includes (i) 4,792 shares of restricted stock for which the risks of forfeiture will lapse as to 1,598 shares on 2/20/21 and as to 1,597 shares on each of 2/20/22 and 2/20/23; (ii) 43,104 shares of restricted stock for which the risks of forfeiture will lapse as to 14,368 shares on each of 10/23/21, 10/23/22 and 10/23/23; and (iii) 14,247 shares of restricted stock for which the risks of forfeiture will lapse as to 3,562 shares on each of 3/16/21, 3/16/22 and 3/16/23 and 3,561 shares on 3/16/24.
Fully exercisable.
Options to purchase 1,350 shares vest on each of 11/2/18, 11/2/19, 11/2/20 and 11/2/21.
/s/ Mark Davis
2020-10-23