0001213900-21-005576.txt : 20210201 0001213900-21-005576.hdr.sgml : 20210201 20210201070557 ACCESSION NUMBER: 0001213900-21-005576 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210128 FILED AS OF DATE: 20210201 DATE AS OF CHANGE: 20210201 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Eriksen Howard Timothy CENTRAL INDEX KEY: 0001650715 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38838 FILM NUMBER: 21574316 BUSINESS ADDRESS: BUSINESS PHONE: 360.393.3019 MAIL ADDRESS: STREET 1: 567 WILDROSE CIRCLE CITY: LYNDEN STATE: WA ZIP: 98264 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: TSR INC CENTRAL INDEX KEY: 0000098338 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMPUTER PROGRAMMING SERVICES [7371] IRS NUMBER: 132635899 STATE OF INCORPORATION: DE FISCAL YEAR END: 0531 BUSINESS ADDRESS: STREET 1: 400 OSER AVE CITY: HAUPPAUGE STATE: NY ZIP: 11788 BUSINESS PHONE: 5162310333 MAIL ADDRESS: STREET 1: 400 OSER AVENUE CITY: HAUPPAUGE STATE: NY ZIP: 11788 FORMER COMPANY: FORMER CONFORMED NAME: TIME SHARING RESOURCES INC DATE OF NAME CHANGE: 19840129 4 1 ownership.xml OWNERSHIP DOCUMENT X0306 4 2021-01-28 0 0000098338 TSR INC TSRI 0001650715 Eriksen Howard Timothy 567 WILDROSE CIRCLE LYNDEN WA 98264 1 0 0 0 Common Stock, $0.01 par value 2021-01-28 4 A 0 20000 0.00 A 20000 D Common Stock, $0.01 par value 2021-01-28 4 A 0 10000 0.00 A 30000 D Represents restricted stock award granted under the TSR, Inc. 2020 Equity Incentive Plan. The shares of restricted stock will remain subject to forfeiture during three years, during such time the forfeiture restrictions will lapse with respect to 10,000 shares, 5,000 shares and 5,000 shares respectively on each anniversary date of the grant date. The lapse of the forfeiture restrictions is conditioned on the reporting person continuing to provide services to TSR, Inc. (the "Company") through each vesting date. Represents restricted stock award granted under the TSR, Inc. 2020 Equity Incentive Plan. The shares of restricted stock will remain subject to forfeiture over three years until the Company's common stock have traded at certain pre-determined price thresholds for a 30-trading-day period. Once a price threshold was achieved by certain target dates, the forfeiture restrictions for the portion of the award related to that threshold will lapse, provided that the reporting person continues to provide services to the Company at the time of vesting. /s/ H. Timothy Eriksen 2021-02-01