0000905718-21-000368.txt : 20210302 0000905718-21-000368.hdr.sgml : 20210302 20210302200435 ACCESSION NUMBER: 0000905718-21-000368 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210227 FILED AS OF DATE: 20210302 DATE AS OF CHANGE: 20210302 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Klaff Hersch CENTRAL INDEX KEY: 0001654577 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39350 FILM NUMBER: 21706407 MAIL ADDRESS: STREET 1: 250 PARKCENTER BLVD. CITY: BOISE STATE: ID ZIP: 83706 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Albertsons Companies, Inc. CENTRAL INDEX KEY: 0001646972 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-GROCERY STORES [5411] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 0227 BUSINESS ADDRESS: STREET 1: 250 PARKCENTER BLVD. CITY: BOISE STATE: ID ZIP: 83706 BUSINESS PHONE: 208-395-6200 MAIL ADDRESS: STREET 1: 250 PARKCENTER BLVD. CITY: BOISE STATE: ID ZIP: 83706 4 1 albertsons_fm4feb272021.xml X0306 4 2021-02-27 0 0001646972 Albertsons Companies, Inc. ACI 0001654577 Klaff Hersch C/O ALBERTSONS COMPANIES, INC. 250 PARKCENTER BLVD. BOISE ID 83706 1 0 1 1 See Remarks Class A common stock, par value $0.01 2021-02-27 4 M 0 9552 A 9552 D Class A common stock, par value $0.01 58128749 I See footnote Restricted Stock Unit 2021-02-27 4 M 0 9552 D Class A common stock, par value $0.01 9552 0 D Each restricted stock unit represents a contractual right to receive one share of Class A common stock of Albertsons Companies, Inc. The awards vested in full on February 27, 2021. The securities reported herein are held by one or more affiliates of Klaff Realty, LP ("Klaff Realty"). Hersch Klaff (the "Reporting Person") expressly disclaims beneficial ownership of the reported shares except to the extent of his pecuniary interest therein through his indirect interest in Klaff Realty or such affiliates. Klaff Realty, LP ("Klaff Realty") through its affiliates has entered into a stockholders agreement, dated June 25, 2020 (the "Stockholders Agreement"), among the Company and certain holders of Company Class A common stock (together with Klaff Realty, the "Sponsors"). Pursuant to the Stockholders Agreement, the Sponsors have agreed to act in concert and vote together on certain matters relating to the Company. As a result, the Sponsors in the aggregate may be deemed to beneficially own more than 10% of the outstanding shares of Company Class A common stock. Hersch Klaff (the "Reporting Person") may be deemed the indirect beneficial owner of the shares held by affiliates of Klaff Realty through his indirect interest in Klaff Realty and/or one or more of his affiliates. However, the Reporting Person and his affiliates do not have a pecuniary interest in the securities of the Company held by the other Sponsors. /s/ Laura A. Donald, Attorney-in-Fact for Hersch Klaff 2021-03-02