0001592379-16-000175.txt : 20161201
0001592379-16-000175.hdr.sgml : 20161201
20161201131439
ACCESSION NUMBER: 0001592379-16-000175
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20161129
FILED AS OF DATE: 20161201
DATE AS OF CHANGE: 20161201
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Papa Murphy's Holdings, Inc.
CENTRAL INDEX KEY: 0001592379
STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-EATING PLACES [5812]
IRS NUMBER: 272349094
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 8000 NE PARKWAY DRIVE
STREET 2: SUITE 350
CITY: VANCOUVER
STATE: WA
ZIP: 98662
BUSINESS PHONE: 360 260-7272
MAIL ADDRESS:
STREET 1: 8000 NE PARKWAY DRIVE
STREET 2: SUITE 350
CITY: VANCOUVER
STATE: WA
ZIP: 98662
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Tipp Jayson
CENTRAL INDEX KEY: 0001606721
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36432
FILM NUMBER: 162027625
MAIL ADDRESS:
STREET 1: C/O PAPA MURPHY'S HOLDINGS, INC.
STREET 2: 8000 NE PARKWAY DRIVE, SUITE 350
CITY: VANCOUVER
STATE: WA
ZIP: 98662
4
1
wf-form4_148061606643501.xml
FORM 4
X0306
4
2016-11-29
0
0001592379
Papa Murphy's Holdings, Inc.
FRSH
0001606721
Tipp Jayson
C/O PAPA MURPHY'S HOLDINGS, INC.
8000 NE PARKWAY DRIVE, SUITE 350
VANCOUVER
WA
98662
0
1
0
0
SVP Tech & Chief Develop Off
Common Stock, par value $0.01 per share
2016-11-29
4
P
0
4100
4.8398
A
34223
D
Common Stock, par value $0.01 per share
10000
I
By IRA
Common Stock, par value $0.01 per share
910
I
By children
Shares are held by an IRA trust for the benefit of the Reporting Person.
The reported securities are held in custodial account for the benefit of the Reporting Person's minor children. The Reporting Person disclaims beneficial ownership of these securities except to the extent of any pecuniary interest therein.
/s/ Daniel R. Smith attorney-in-fact
2016-12-01