0001104659-23-029143.txt : 20230306 0001104659-23-029143.hdr.sgml : 20230306 20230306182538 ACCESSION NUMBER: 0001104659-23-029143 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230302 FILED AS OF DATE: 20230306 DATE AS OF CHANGE: 20230306 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Lunan Karla CENTRAL INDEX KEY: 0001903946 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35629 FILM NUMBER: 23710365 MAIL ADDRESS: STREET 1: C/O TILE SHOP HOLDINGS, INC. STREET 2: 14000 CARLSON PKWY. 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 tm238679-4_4seq1.xml OWNERSHIP DOCUMENT X0306 4 2023-03-02 0 0001552800 TILE SHOP HOLDINGS, INC. TTSH 0001903946 Lunan Karla C/O TILE SHOP HOLDINGS, INC. 14000 CARLSON PARKWAY PLYMOUTH MN 55441 0 1 0 0 Chief Financial Officer Common Stock 2023-03-02 4 D 0 6165 0 D 24658 D Represents forfeiture of unvested performance-based restricted stock granted in 2022 as a result of the applicable performance targets not being achieved. Includes (i) 10,274 shares of restricted stock for which the risks of forfeiture will lapse in three equal annual installments on each of 3/7/23, 3/7/24, and 3/7/25; and (ii) 14,384 shares of performance-based restricted stock for which the risks of forfeiture will lapse as to 30% and 40% of the initial number of shares granted on each of the dates that the Issuer files its annual report for the years ending December 31, 2023 and 2024, respectively, subject to Ms. Lunan remaining in continuous employment with the Issuer prior to and as of December 31 of the year preceding the applicable vesting date and the Issuer achieving its performance target for each respective year. The Issuer's proxy statement contains additional information regarding the applicable performance targets. /s/ Karla Lunan 2023-03-06