0001104659-24-036298.txt : 20240319 0001104659-24-036298.hdr.sgml : 20240319 20240319202150 ACCESSION NUMBER: 0001104659-24-036298 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20240315 FILED AS OF DATE: 20240319 DATE AS OF CHANGE: 20240319 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Davis Mark Burton CENTRAL INDEX KEY: 0001787766 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35629 FILM NUMBER: 24765894 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] ORGANIZATION NAME: 07 Trade & Services 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 tm249293-1_4seq1.xml OWNERSHIP DOCUMENT X0508 4 2024-03-15 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 0 Common Stock 2024-03-15 4 F 0 912 6.53 D 115589 D Common Stock 2024-03-16 4 F 0 1279 6.61 D 114310 D Stock Option (Right to Buy) 8.5 2027-11-06 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) 2,568 shares of restricted stock for which the risks of forfeiture will lapse on 3/7/25; (ii) 6,173 shares of restricted stock for which the risks of forfeiture will lapse in equal annual installments on each of 3/6/25 and 3/6/26; (iii) 7,562 shares for which the risks of forfeiture will lapse in equal annual installments on each of 3/4/25, 3/4/26 and 3/4/27; and (iv) the following shares of performance-based restricted stock, which are, in each case, subject to Mr. Davis remaining in continuous employment with the Issuer through December 31 of the year preceding the applicable vesting date and the Issuer achieving its performance target for each respective year: (A) 6,165 shares for which the risks of forfeiture will lapse on the date the Issuer files its annual report for the 2024 fiscal year; (B) 12,963 shares 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 the Issuer files its annual report for the 2024 and 2025 fiscal years, respectively; and (C) 15,125 shares for which the risks of forfeiture will lapse as to 30%, 30% and 40% on each of the dates the Issuer files its annual report for the 2024, 2025 and 2026 fiscal years, respectively. The Issuer's proxy statement contains additional information regarding the applicable performance targets. Fully exercisable. /s/ Mark B. Davis 2024-03-19