SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

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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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
GROSS MURRAY H

(Last) (First) (Middle)
405 STATE HIGHWAY 121 BYPASS
BUILDING A, SUITE 250

(Street)
LEWISVILLE TX 75067

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
US HOME SYSTEMS INC [ USHS ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
X Officer (give title below) Other (specify below)
Chairman & CEO
3. Date of Earliest Transaction (Month/Day/Year)
12/22/2010
4. 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 Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 12/22/2010 M 10,000 A $1.85 549,283 I See Footnote.(1)
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Employee Stock Option (right to buy) $1.85 12/22/2010 M 10,000 11/11/2008 11/11/2018 Common Stock 10,000 $0 50,000(2) D
Explanation of Responses:
1. After all reported transaction, Mr. Gross owns 549,283 shares of common stock which includes 283,793 shares held by About Face, Ltd., 200,390 shares held by BLG Partners, 15,000 owned directly by Mr. Gross, 10,000 shares held in this IRA account and includes presently execusable options to purchase 40,000 shares. About Face Ltd. is a family limited partnership, the partners of which are Mr. Gross and spouse, each of whom own a 49.5 interest in the partnership. GP About Face Ltd is the general partner and holds a 1% interest in the partnership. BLG Partners is a general partnership of which Mr. Gross and his spouse are partners. Mr. Gross has sole investment and voting power over the shares owned by both partnerships.
2. Includes vested options to purchase 40,000 shares at $1.85 per share until 11/11/2018 when the options expire. Also includes unvested options to purchase 10,000 shares at $2.51 per share. The options vest 33 1/3% on March 15, 2011 and 33 1/3% on each March 15 thereafter until 3/15/2013 when options are fully vested. The options expire on March 15, 2020.
/s/Murray H. Gross 12/27/2010
** 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 4 (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).
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