0001209191-17-040151.txt : 20170615 0001209191-17-040151.hdr.sgml : 20170615 20170615162712 ACCESSION NUMBER: 0001209191-17-040151 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170613 FILED AS OF DATE: 20170615 DATE AS OF CHANGE: 20170615 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: GOLDEN ENTERTAINMENT, INC. CENTRAL INDEX KEY: 0001071255 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MISCELLANEOUS AMUSEMENT & RECREATION [7990] IRS NUMBER: 411913991 STATE OF INCORPORATION: MN FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 6595 S JONES BLVD CITY: LAS VEGAS STATE: NV ZIP: 89118 BUSINESS PHONE: 7028914284 MAIL ADDRESS: STREET 1: 6595 S JONES BLVD CITY: LAS VEGAS STATE: NV ZIP: 89118 FORMER COMPANY: FORMER CONFORMED NAME: LAKES ENTERTAINMENT INC DATE OF NAME CHANGE: 20020806 FORMER COMPANY: FORMER CONFORMED NAME: LAKES GAMING INC DATE OF NAME CHANGE: 19980929 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: MIODUNSKI ROBERT L CENTRAL INDEX KEY: 0001194916 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-24993 FILM NUMBER: 17913794 MAIL ADDRESS: STREET 1: 6601 S BERMUDA RD CITY: LAS VEGAS STATE: NV ZIP: 89119 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2017-06-13 0 0001071255 GOLDEN ENTERTAINMENT, INC. GDEN 0001194916 MIODUNSKI ROBERT L 6595 S. JONES BLVD. LAS VEGAS NV 89118 1 0 0 0 Stock Option (right to buy) 20.06 2017-06-13 4 A 0 20000 0.00 A 2027-06-12 Common Stock 20000 20000 D The option vests on June 13, 2018. Notwithstanding the foregoing vesting schedule, in no event may the option be exercised prior to the earlier of (i) 08/01/18, or (ii) immediately prior to the consummation of a "change in control" under Section 2.8(a), (c) or (d) of the 2015 Incentive Award Plan which results in an "ownership change" as defined in Section 382 of the Internal Revenue Code of 1986, as amended, or any successor statute. /s/ Robert L. Miodunski 2017-06-14