SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person*
Jacobs Daniel DeHart

(Last) (First) (Middle)
2645 SILVER CRESCENT DRIVE

(Street)
CHARLOTTE NC 28273

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
02/06/2024
3. Issuer Name and Ticker or Trading Symbol
JELD-WEN Holding, Inc. [ JELD ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
VP & GM, North America Windows
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock 40,472(1) D
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Common Stock Option (Right to Buy) (2) 02/26/2028 Common Stock 3,712 $33.34 D
Explanation of Responses:
1. The reported transaction includes the following awards made in respect of the issuer's common stock, the vesting of which is subject to the reporting person's continued employment with the issuer:(i) 3,746 restricted stock units granted on February 23, 2021, the remaining 1/3 of which shall vest on February 23, 2024, (ii) 5,808 restricted stock units granted on February 16, 2022, the remaining 2/3 of which shall vest on February 16, 2024 and February 16, 2025, (iii) 15,806 restricted stock units granted on June 1, 2022, which shall vest in full on June 1, 2025, (iv) 10,000 restricted stock units granted on February 14, 2023, which shall vest ratably on February 14, 2024, February 14, 2025, and February 14, 2026, (v) 2,500 restricted stock units granted on February 14, 2023, which shall vest on 1/2 in years two and three, and (vi) 7,000 restricted stock units granted on September 1, 2023, which shall vest ratably on September 1, 2024 and September 1, 2025.
2. The award is fully vested.
Remarks:
/s/Daniel DeHart Jacobs 02/08/2024
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
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