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