0001209191-21-040149.txt : 20210614 0001209191-21-040149.hdr.sgml : 20210614 20210614114701 ACCESSION NUMBER: 0001209191-21-040149 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210601 FILED AS OF DATE: 20210614 DATE AS OF CHANGE: 20210614 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Larson Timothy Mark CENTRAL INDEX KEY: 0001867111 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-04714 FILM NUMBER: 211013789 MAIL ADDRESS: STREET 1: C/O SKYLINE CHAMPION CORPORATION STREET 2: 755 W. BIG BEAVER RD., SUITE 1000 CITY: TROY STATE: MI ZIP: 48084 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Skyline Champion Corp CENTRAL INDEX KEY: 0000090896 STANDARD INDUSTRIAL CLASSIFICATION: MOBILE HOMES [2451] IRS NUMBER: 351038277 STATE OF INCORPORATION: IN FISCAL YEAR END: 0328 BUSINESS ADDRESS: STREET 1: 755 W BIG BEAVER ROAD STREET 2: SUITE 1000 CITY: TROY STATE: MI ZIP: 48084 BUSINESS PHONE: 248 614 8211 MAIL ADDRESS: STREET 1: 755 W BIG BEAVER ROAD STREET 2: SUITE 1000 CITY: TROY STATE: MI ZIP: 48084 FORMER COMPANY: FORMER CONFORMED NAME: SKYLINE CORP DATE OF NAME CHANGE: 19920703 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2021-06-01 0 0000090896 Skyline Champion Corp SKY 0001867111 Larson Timothy Mark 755 W. BIG BEAVER ROAD SUITE 1000 TROY MI 48084 0 1 0 0 Chief Growth Officer Common Stock 2021-06-01 4 A 0 5227 0.00 A 5227 D Common Stock 2021-06-01 4 A 0 6098 0.00 A 11325 D Stock Options (Right to Buy) 53.06 2021-06-01 4 A 0 12616 0.00 A 2031-06-01 Common Stock 12616 12616 D Represents restricted stock units ("RSUs") granted to the Reporting Person under the Issuer's 2018 Equity Incentive Plan. Each RSU represents the contingent right to receive one share of Common Stock. Subject to the terms of the award agreement evidencing the grant of the RSUs, one-third of the RSUs vests on each of the first three anniversaries of June 1, 2021, provided that the Reporting Person remains in continuous service with the Issuer through each vesting date. Represents performance-based restricted stock units ("PRSUs") granted to the Reporting Person under the Issuer's 2018 Equity Incentive Plan. Each PRSU represents the contingent right to receive one share of Common Stock. Subject to the terms of the award agreement evidencing the grant of the PRSUs, vesting of a percentage of the PRSUs (including up to 150%) is dependent on the Issuer's total shareholder return from June 1, 2021 through June 1, 2024 relative to the total shareholder return of certain other companies over that same time period, provided that the Reporting Person remains in continuous service with the Issuer through each vesting date. The stock options will vest as to one-third of the shares subject to the stock option on each of of the first three anniversaries of June 1, 2021, provided that the Reporting Person remains in continuous service with the Issuer through each vesting date. /s/ Caren A. Ries, Attorney-in-Fact 2021-06-14