|
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN 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 |
|
| |||||||||||||||||||||||||||||
| |||||||||||||||||||||||||||||
| Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
| Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. | SEC 1474 (9-02) | ||
| 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 Underlying Securities (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 of Derivative Security: 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 | ||||||||
| Restricted Stock Units - QRTEA | (1) | 12/06/2021 | A | 14,188 | 12/06/2022 | 12/06/2022 | Series A Common Stock | 14,188 | $ 0 | 14,188 | D | ||||
| Stock Option (right to buy) - QRTEA | $ 4.21 (2) | (3) | 12/09/2026 | Series A Common Stock | 82,297 (2) | 82,297 (2) | D | ||||||||
| Stock Option (right to buy) - QRTEA | $ 8.84 (4) | 12/10/2021 | 12/10/2027 | Series A Common Stock | 27,198 (4) | 27,198 (4) | D | ||||||||
| Stock Option (right to buy) - QRTEA | $ 10.8 (5) | (3) | 12/06/2025 | Series A Common Stock | 32,460 (5) | 32,460 (5) | D | ||||||||
| Stock Option (right to buy) - QRTEA | $ 11.5 (6) | (3) | 12/12/2023 | Series A Common Stock | 26,897 (6) | 26,897 (6) | D | ||||||||
| Stock Option (right to buy) - QRTEA | $ 11.85 (7) | (3) | 12/12/2024 | Series A Common Stock | 21,597 (7) | 21,597 (7) | D | ||||||||
| Stock Option (right to buy) - QRTEA | $ 12.82 (8) | (3) | 12/17/2022 | Series A Common Stock | 19,236 (8) | 19,236 (8) | D | ||||||||
| Reporting Owner Name / Address | Relationships | |||
| Director | 10% Owner | Officer | Other | |
| ROMRELL LARRY E 12300 LIBERTY BOULEVARD ENGLEWOOD, CO 80112 |
X | |||
| /s/ Brittany A. Uthoff as Attorney-in-Fact for Larry E. Romrell | 12/08/2021 | |
| **Signature of Reporting Person | Date |
| * | 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). |
| (1) | Each restricted stock unit represents a contingent right to receive one share of Series A Common Stock. |
| (2) | On November 4, 2021, the Issuer announced that its board of directors declared a special cash dividend in the amount of $1.25 per common share payable on November 22, 2021, to all holders of record of the Issuer's common stock at the close of business on November 15, 2021 (the "Dividend"). This stock option award was previously reported as an option relating to 70,209 shares of the Issuer's Series A common stock at an exercise price of $4.92 per share and was adjusted as a result of the Dividend. In connection with the Dividend, all common stock options held by the reporting person were adjusted pursuant to the anti-dilution provisions of the incentive plan under which such award was granted, such that the reporting person received an adjustment to (i) the exercise price and (ii) the number of shares relating to such option. These adjustments were approved by the Issuer's board of directors pursuant to Rule 16b-3 of the Securities Exchange Act of 1934, as amended ("Rule 16b-3"). |
| (3) | The derivative security is fully vested. |
| (4) | This stock option award was previously reported as an option relating to 24,726 shares of the Issuer's Series A common stock at an exercise price of $10.34 per share and was adjusted as a result of the Dividend. In connection with the Dividend, all common stock options held by the reporting person were adjusted pursuant to the anti-dilution provisions of the incentive plan under which such award was granted, such that the reporting person received an adjustment to (i) the exercise price and (ii) the number of shares relating to such option. These adjustments were approved by the Issuer's board of directors pursuant to Rule 16b-3. |
| (5) | This stock option award was previously reported as an option relating to 27,746 shares of the Issuer's Series A common stock at an exercise price of $12.64 per share and was adjusted as a result of the Dividend. In connection with the Dividend, all common stock options held by the reporting person were adjusted pursuant to the anti-dilution provisions of the incentive plan under which such award was granted, such that the reporting person received an adjustment to (i) the exercise price and (ii) the number of shares relating to such option. These adjustments were approved by the Issuer's board of directors pursuant to Rule 16b-3. |
| (6) | This stock option award was previously reported as an option relating to 22,984 shares of the Issuer's Series A common stock at an exercise price of $13.46 per share and was adjusted as a result of the Dividend. In connection with the Dividend, all common stock options held by the reporting person were adjusted pursuant to the anti-dilution provisions of the incentive plan under which such award was granted, such that the reporting person received an adjustment to (i) the exercise price and (ii) the number of shares relating to such option. These adjustments were approved by the Issuer's board of directors pursuant to Rule 16b-3. |
| (7) | This stock option award was previously reported as an option relating to 18,453 shares of the Issuer's Series A common stock at an exercise price of $13.87 per share and was adjusted as a result of the Dividend. In connection with the Dividend, all common stock options held by the reporting person were adjusted pursuant to the anti-dilution provisions of the incentive plan under which such award was granted, such that the reporting person received an adjustment to (i) the exercise price and (ii) the number of shares relating to such option. These adjustments were approved by the Issuer's board of directors pursuant to Rule 16b-3. |
| (8) | This stock option award was previously reported as an option relating to 16,454 shares of the Issuer's Series A common stock at an exercise price of $15.00 per share and was adjusted as a result of the Dividend. In connection with the Dividend, all common stock options held by the reporting person were adjusted pursuant to the anti-dilution provisions of the incentive plan under which such award was granted, such that the reporting person received an adjustment to (i) the exercise price and (ii) the number of shares relating to such option. These adjustments were approved by the Issuer's board of directors pursuant to Rule 16b-3. |
| Remarks: Exhibit List: Ex. 24 - Power of Attorney. | |