0000914190-19-000234.txt : 20190718 0000914190-19-000234.hdr.sgml : 20190718 20190718163340 ACCESSION NUMBER: 0000914190-19-000234 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190716 FILED AS OF DATE: 20190718 DATE AS OF CHANGE: 20190718 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: LIVINGSTON PHILIP B CENTRAL INDEX KEY: 0001020149 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-ADVERTISING AGENCIES [7311] STATE OF INCORPORATION: DE FISCAL YEAR END: 0331 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35629 FILM NUMBER: 19961648 MAIL ADDRESS: STREET 1: 1241 EAST MAIN ST CITY: STAMFORD STATE: CT ZIP: 06902 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: TILE SHOP HOLDINGS, INC. CENTRAL INDEX KEY: 0001552800 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-HOME FURNITURE, FURNISHINGS & EQUIPMENT STORES [5700] IRS NUMBER: 455538095 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 14000 CARLSON PARKWAY CITY: PLYMOUTH STATE: MN ZIP: 55441 BUSINESS PHONE: 763-852-2950 MAIL ADDRESS: STREET 1: 14000 CARLSON PARKWAY CITY: PLYMOUTH STATE: MN ZIP: 55441 4 1 edgar.xml PRIMARY DOCUMENT X0306 4 2019-07-16 0001552800 TILE SHOP HOLDINGS, INC. TTS 0001020149 LIVINGSTON PHILIP B C/O TILE SHOP HOLDINGS, INC. 14000 CARLSON PARKWAY PLYMOUTH MN 55441 1 0 0 0 Common Stock 2019-07-16 4 A 0 17200 0 A 56083 D Represents 17,200 shares of restricted stock granted pursuant to the Company's 2012 Omnibus Award Plan, which are subject to a risk of forfeiture until the earlier of (a) the date of the Company's next annual meeting of stockholders and (b) July 16, 2020. /s/ Amanda Lorentz as Attorney-in-Fact for Philip B. Livingston pursuant to Power of Attorney previously filed. 2019-07-18