0001140361-16-089674.txt : 20161214
0001140361-16-089674.hdr.sgml : 20161214
20161214164126
ACCESSION NUMBER: 0001140361-16-089674
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20161214
FILED AS OF DATE: 20161214
DATE AS OF CHANGE: 20161214
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Extended Stay America, Inc.
CENTRAL INDEX KEY: 0001581164
STANDARD INDUSTRIAL CLASSIFICATION: HOTELS & MOTELS [7011]
IRS NUMBER: 463140312
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 11525 N. COMMUNITY HOUSE ROAD, SUITE 100
CITY: CHARLOTTE
STATE: NC
ZIP: 28277
BUSINESS PHONE: (980) 345-1600
MAIL ADDRESS:
STREET 1: 11525 N. COMMUNITY HOUSE ROAD, SUITE 100
CITY: CHARLOTTE
STATE: NC
ZIP: 28277
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: WALLMAN RICHARD F
CENTRAL INDEX KEY: 0001198092
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36190
FILM NUMBER: 162051525
MAIL ADDRESS:
STREET 1: HONEYWELL
STREET 2: 101 COLUMBIA ROAD
CITY: MORRISTOWN
STATE: NJ
ZIP: 07962
4
1
doc1.xml
FORM 4
X0306
4
2016-12-14
0
0001581164
Extended Stay America, Inc.
STAY
0001198092
WALLMAN RICHARD F
C/O EXTENDED STAY AMERICA, INC.
11525 N. COMMUNITY HOUSE ROAD, SUITE 100
CHARLOTTE
NC
28277
1
0
0
0
Paired Shares
2016-12-14
4
G
0
18042
0.00
D
111100
D
Paired Shares
80005
I
See footnote
Paired Shares
9800
I
See footnote
Paired Shares
13800
I
Spouse IRA
Paired Shares
18200
I
Spouse SEP
Each Paired Share is comprised of one share of common stock, par value $0.01 per share, of Extended Stay America, Inc. and one share of Class B common stock, par value $0.01 per share, of ESH Hospitality, Inc., which shares are paired and traded as a single unit.
The reported transaction is a bona fide gift of Paired Shares to the Wallman Family Fund, a Fidelity Charitable donor-advised fund. A Form 4 reflecting the transaction in Paired Shares by the reporting person shown on this Form 4 has been concurrently filed with respect to ESH Hospitality, Inc. as issuer.
These Paired Shares are held through the Richard F. Wallman IRA, an individual retirement account for which the reporting person is a fiduciary.
These Paired Shares are held through the Richard F. Wallman SEP, an individual retirement account for which the reporting person is a fiduciary.
/s/ Christopher Dekle, Attorney-in-Fact for Richard F. Wallman
2016-12-14