0000899243-21-041290.txt : 20211022 0000899243-21-041290.hdr.sgml : 20211022 20211022172357 ACCESSION NUMBER: 0000899243-21-041290 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211021 FILED AS OF DATE: 20211022 DATE AS OF CHANGE: 20211022 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Dussinger Patrick CENTRAL INDEX KEY: 0001819339 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38632 FILM NUMBER: 211341549 MAIL ADDRESS: STREET 1: 400 GALLERIA PKWY SE STREET 2: SUITE 1760 CITY: ATLANTA STATE: GA ZIP: 30339 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Select Interior Concepts, Inc. CENTRAL INDEX KEY: 0001723866 STANDARD INDUSTRIAL CLASSIFICATION: GEN BUILDING CONTRACTORS - RESIDENTIAL BUILDINGS [1520] IRS NUMBER: 474640296 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 400 GALLERIA PARKWAY STREET 2: SUITE 1760 CITY: ATLANTA STATE: GA ZIP: 30339 BUSINESS PHONE: (888)701-4737 MAIL ADDRESS: STREET 1: 400 GALLERIA PARKWAY STREET 2: SUITE 1760 CITY: ATLANTA STATE: GA ZIP: 30339 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2021-10-21 1 0001723866 Select Interior Concepts, Inc. SIC 0001819339 Dussinger Patrick 400 GALLERIA PARKWAY, SUITE 1760 ATLANTA GA 30339 0 1 0 0 President-ASG Class A Common Stock 2021-10-21 4 D 0 115651 14.50 D 0 D Restricted Sock Units 2021-10-21 4 D 0 112500 14.50 D Common Stock 125000 0 D Includes time-vesting restricted stock units (RSUs) convertible into shares of Class A Common Stock. Disposed of pursuant to merger agreement between issuer and Astro Stone Intermediate holding, LLC in exchange for a cash payment equal to the per share merger consideration ($14.50). Reflects performance-based RSUs that each represented a contingent right to receive one share of Class A Common Stock based on the closing price of the Issuer's common stock exceeding specific hurdles for 20 consecutive trading days, and subject to the reporting person's continued employment with the Issuer. /s/ Scott Jarvis, attorney-in-fact 2021-10-22